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Amount: $ ( 03 <br /> Initials: f'r1 <br /> REQUEST FOR REPRINT OF OVERSIZED DOCUMENTS <br /> OR BUILDING PLANS AND BLUEPRINTS <br /> Date of Request: 3 — S- c' <br /> / <br /> Name: . c Al <br /> f 0 e 4 /1._ <br /> Address: Cr) (A.-) n - c( rn ryl P L— -C <br /> City: State: Zip: <br /> Phone: (Work) (Home) f S _ %a— 4 3 S'C <br /> Description of document(s) to be reprinted: (o !/ c� u.S E Pl q 0.5-5 <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 /> Building Plans and Blueprints <br /> The charge for such reprints is the cost of copying service, Messenger service and a minimum <br /> clerical fee of $5.00. <br /> All charges must be paid at the time of the request, and are non-refundable. Requests must <br /> be picked up at the City offices unless other arrangements have been made. If prints are <br /> delivered and picked up by a courier service, the charge for such service is to be paid by <br /> requestor. <br /> ( S 0 <br /> 53 � �. r <br /> Signature <br /> J . U( ^d r <br /> X:\APPS\WP WIN60\WPDOCS\DEPCLERK\FORMS\REPRINT.FRM <br /> j2,Cek -s- 0/ 1 D$ JI <br /> 3 <br /> CSC <br />