Laserfiche WebLink
A <br /> AIT10LUlt: $ ��.�2 <br /> TIllt1�S: ,��, <br /> REQUEST FOR REPRINT OF OVERSIZED DOCUMENTS <br /> OR BUII,DING PLANS AND BLUEPRINTS <br /> Date of Request: '�f3�0 � <br /> Name: �.ac.��•�C.��L.l.L« <br /> Address: .�,�/f'p��.�,�r�,l�rL• <br /> -�, __ <br /> City: ���,��.� State: 1�� Zip: S�'3 3i <br /> Phone: (Work)��'-,Z/ 7�' (Home) �O�.- ��/g <br /> Description of document(s) to be reprinted: /�' fi'� � � ��,�„ -rk.v: <br /> 7��! ���c.z:i ��L� a f _r�c i. <br /> � <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 Blueprirlts <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 aze non-refundable. Requests must <br /> be picked up at the City offices unless other anangements 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 /> -�.�o � /� ��''!�7 <br /> .6� K /,�' S.?�' <br /> � ���� Signature <br /> �.�'7 <br /> 'r/��f..1.Z <br /> ��.�� a °o <br /> ,e:G.tk..G �T��.� s.�.7s.. <br /> X:44PPS�WPWIN60\WPDOCS�DEPCLERK�FORMSIREPRINT.FRM ' <br />