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Dec-06 DEC 86 '01 , 12:26PM ORONO +5522494E16 T-314 P 00Z/00Z <br /> LDIn C-0 l /1 Cte S1 <br /> _.11,trg-Pcf,,aPe' <br /> Amount: <br /> Initials: <br /> REQUEST FOR REPRINT OF OVERSIZED DOCUMENTS $� �� " <br /> OR BUILDING PLANS.AND.BLUEPRINTS. /A/1• <br /> • <br /> Date of Request: l 2 1 to J D 1 • <br /> Name: /Zct_r "v‘. A Ji Tede--e-, <br /> F a h y :re,/ k� � � " /l Address: Clo)6G �' r�� /lQ' •/U� <br /> City: /22 , 6L3 State: /214) Zip: tcSYo <br /> Phone: (Work) (P I f Mc ' Q`ll - (Home) <br /> Description of document(s) to be reprinted: <br /> k)USS Viae O(c CU'I l d hu r s-k- T2 - <br /> CHARGES: (the following charges are subject to rate changes) <br /> Oversized Documents from Microfilm <br /> The charge for such reprints is the cost of copying service, Messenger service and a minimum <br /> clerical fee of $5.00. <br /> BuilditZ� ans and Blueprints <br /> The charge for such reprints is the cost of copying service, Messenger service and a minimum <br /> clerical fee of $5.00. <br /> All charges must be paid at the time of the request, and are non-refundable. Requests must <br /> be picked up at the City offices unless other arrangements have been made. If prints are <br /> delivered and picked up by a courier service, the charge for such service is to be paid by <br /> reouestor. • <br /> 41„,14..c4s <br /> } L • <br /> Signature <br /> 1i' : RET,P )6 !Ili I <br /> f.,J i.i aTIOtfrtiI �c NT.ULM ' <br /> . � <br />