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1-4112, Kb SS „tVA A-\j� <br />CITY OF EVERETT <br />REFUND AUTHORIZATION <br />TO: City Treasurer <br />You are hereby authorized to refund the following: <br />PAYEE ESCOBEDOINDALECIO <br />& 1410 KOSSUTH AVE <br />ADDRESS: EVERETT WA 9820 <br />DATE: May 2, 2018 <br />AMOUNT: $ 30.00 <br />REASON: THIS PERMIT NOT NEEDED, ALREADY HAS THE NECESSARY SERVICE <br />GL CODE: B 002-322-1101-831: <br />M 002-322-1500-831: INVOICE: U1804-043 <br />P 002-322-1300-831: (Please print this number on the refund check) <br />E 002-322-1200-831: <br />PC 002-345-8300-831: <br />002-342-4016-831: <br />002-345-8112-102: <br />002-369-8101-000: <br />002-2374-3401-000: <br />157-345-8601-000: <br />SEWER 401-343-50-109-460-00: $ 30.00 <br />Payment was received by the City of Everett on 05/02/2018 and recorded on U1804-043. <br />May 2, 2018�: <br />(date) (Authorized Signature) <br />Refund by Check No. Date <br />Original Receipt Attached <br />Account Debited: <br />Or refund noted on Treasurer's Office Copy. <br />Paul McKee -Permit Services Manager <br />(Title) <br />,%a <br />