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(11/89 ) <br /> Amount: $ RECEIPT: <br /> Initials <br /> REQIISST FOR REPRINT OF OVERSIZED DOCIIMENTS OR <br /> BIIILDING PLANS AND BLIIE PRINTS <br /> Date of Request: � � /G �' <br /> Name: Kof� �✓ ►� `'� r�- Phone: `7 / 7"' �s7-'� <br /> ,� work) <br /> Address: Q�s ��a�. ,���G�� /t���� ��� - �J � 01. �' <br /> T home <br /> City: ��UYv �� ��:i; u� ���f�,�u <br /> C� rr•r�.•�j� � :-lLrr:� <br /> ! 11�!'!)f-4L LFt ! i U <br /> state: zip: S�3 S �_ ��::;.:C:1%L;t;?� ,+ .�, <br /> � vi u�ii ,.:�ic'�.:,,iv <br /> , e i.i�nF3i. c.'�:.'�..�n� <br /> �•H��'I ��}.iivp <br /> (.C-C�r= :.i niiitt. i i�:,,�iii <br /> Description of document( s ) to be reprinted: � I' ��`t"✓V�, •���.:•_��i�r�• rrrri <br /> i-Ti�iii� ilnivi �Lv <br /> :�:�r�'T?l�t :�rit't 9 i�rz1 �'i't7•ri� <br /> T7L 1 I i1 l•Y1�1 ! V1 !V!�YV <br /> '}f f��f t <br /> VIlL1/ �., <br /> CHARGES: (the following charges are subject to rate changes) <br /> Oversized Documents From Microfilm <br /> The charge for such reprints is 2.50 each. There is an <br /> additional $10 . 00 charge for pickup and delivery. <br /> Building Plans and Blueprints <br /> The charge f or such reprints is $0.12 per square f oot with <br /> no minimum charge. Reprints will be made at: Engineering Repro <br /> Inc., 13700 lst Ave N, Plymouth, MN 55441. Telephone: 473-2902. <br /> All charges must be paid at the time of the request, and are <br /> non-refundable. Requests will require a minimum of three ( 3) <br /> working days to fill , and must be picked up at the City offices <br /> unless other arrangements have been made. If prints are <br /> delivered and picked up by courier service, the charge for such <br /> service is to be paid by requestor. <br /> , <br /> _ � ��� <br /> Si ature <br />