Laserfiche WebLink
CITY OF EVERETT <br /> REFUND AUTHORiZATION <br /> TO: City Treasurer DATE: 10/15/04 <br /> You are hereby authorized to refund the following: <br /> PAYEE Dean Eldridge <br /> 8 c/o Keith Hemstreet <br /> ADDRESS: ?-:oo i CF 45'"Way <br /> Issaquah, Yu� 98029 <br /> � <br /> AMOUNT: $ 140.00 <br /> REASON: Paid pl �r�n61np fee for 48 washers The CitKr�q�red him to reduce the numher to 34. <br /> 14 x 10.00 = 140.00 <br /> CUSTOMER ACCOUNT# 002-322-1300-831 <br /> This amount was received by the City of Everett on 10/11/04 and recorded on permit or receipt number <br /> C0409-028 <br /> 10/15/04 �.I(/7� <br /> (dale) (A ortzed Slpnature) <br /> Parmit Sarvirws Ma�aQe� <br /> (7IUe)- -- - <br /> Refund by Check No. Date <br /> _Original Receipt Attached <br /> Account Debited: ,h�.•ck d;�fE /0/Z2 <br /> Or refund noted on Treasurer's Office Copy. <br /> �i <br />