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'0 -�► <br /> �O� <br /> � ��� � <br /> ,� ���� ,, Request for.Reprint of Oversized Documents <br /> �'� �' ' � �� or Building Plans and Blueprints <br /> ��kEsHo4� <br /> Date of Request: <br /> DocumentAddress: %�vG' �- /'�Lr� f f�(Lf�.C� �`-� <br /> Name: j��� f/� � � �QU vrL L�" <br /> Address: ��C> �u,y�; �,�},�p� ��sf} �j <br /> City: (T/,F'�j,/,�1 State: �n/ Zip: S�3Si� <br /> Phone: �I S,� -- L/f��•- �U� ,6 <br /> (Work) (Home or Cell) <br /> Description of document(s) to be reprinted: <br /> CHARGES: All char�es must be paid at the time of the request, and are non-refundable. <br /> Requests must be picked up at the City offices unless other arrangements have been made. The <br /> charges for reprints of oversized documents and building plans/blueprints are based on the <br /> following: <br /> Cost of ls� Prints �@ $ � L���� ea. _ � � � �� <br /> Additional Prints @ $ ea. _ <br /> Cost to Scan � @ $ 5.00 ea. _ �� � . U� <br /> Special Handling Fee �� � ��..-� <br /> Pickup/Delivery Fee 17.00 <br /> Set-up Charge 20.00 <br /> Energy Charge 2.29 <br /> Subtotal �;��> > cj <br /> 6.5% Tax � 5� <br /> Clerical Fee 5.00 <br /> ___�__ <br /> TOTAL � �j , �� � <br /> (signature) <br /> 2750 Kelley Parkway,P.O.Box 66,Crystal Bay, MN 55323 <br /> Phone: J�2-249-4600/Fax: 952-24)-4616/www.ci.orono.mn.us <br />