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Amount: $ <br /> Initials: <br /> REQUEST FOR REPRINT OF OVERSIZED DOCUMENTS <br /> OR BUILDING PLANS AND BLUEPRINTS <br /> Date of Request: ` �/ — /� � � 7 <br /> Name: `�e r.� � �...r�- <br /> Address: T�3 0 (,.` e�-� 4 �,-f-e �ol � <br /> City: �� ,,,_, ,,,,�,��r,.. �.� State: �� . Zip: �S S 3 �S— • <br /> Phone: (Work) �3S - 7 7 d- S (Home) �3`—,7a 3 3 <br /> Description of document(s) to be reprinted: , ���-u.�� �t�'-�riy� � ��2/r �-�+'�.'-�,✓�-�-�-P �C� <br /> / �i <br /> CHARGES: (the follo�,ving c:�arges 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 /> Buildin� 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 ut the Ciry offzc�s unless other arrangements have been made. If prints are <br /> delivered an� �ick�d up by a courier service, the charge for such service is to be paid by <br /> requestor. <br /> (o P��-�' j( �.�o � 3� �� <br /> �,�,�. <br /> Signature <br /> �� l,�. �- <br /> � ,ov <br /> (�.��� �X � -�3 _ <br /> sa s3 <br />