Two weeks ago, we had a meeting with a government agency with a project that we are doing. And, given the nature of the project, it required coordination/approval with this government agency.
So I called the government guy and asked him how many copies of our project document (1100 pages) he needed for his agency in order to review it. He e-mailed me back and said that they do no use "paper" submissions anymore, and that they use only use electronic submissions. And he sent me a link to use to submit it, along with instructions.
So, we used his link to send in our 1100-page document (pdf).
And, he and his co-workers used Adobe Acrobat to mark up their comments on our pdf.
So, two weeks ago we had a meeting with the government agency at their office to review our project. And for the meeting, which included a total of 23 people, the government guy printed 23 color copies of the 1100-page document with the mark-ups and handed them out at the meeting.