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CITY OF EVERETT <br /> REFUND AUTHORIZATION <br /> TO: City Treasurer DATE: November 20, 2014 <br /> You are hereby authorized to refund the following: <br /> PAYEE lin R Rogers [lectrical Inc <br /> g 7.050 Marconi Dr 7l200 <br /> ADDRESS: Alpharetta, GA 30005 <br /> AMOUNT: S 59.92 <br /> REASON Contractor cancelled permit. 5L� 1 EU e.r5 �e er� Way <br /> / <br /> GL CODE: 002-322-1101-831: — <br /> 002-322-1500-831: IhVO1C1', NIs1410-190 <br /> 002-322-1300-831: (plcase prin� �his number an thc rcfund check) <br /> 002-322-1200-831: 59.92 <br /> 002-322-4011-831: <br /> 401-343-50-109-460-00: <br /> 401-343-50-109-460-14: <br /> 401-343-40-119-�171-02 <br /> 002-345-8300-831: <br /> This amount was received by the City o( Everetl on October 30, 2014 and recorded on permit number <br /> [1410-190. , �� <br /> � . �(—�-"'_\G�..�C� <br /> November 20, 2014 _'i� <br /> �---(date) '— (Aultio c Signalur�) <br /> Paul McKee-Permit Services Manager <br /> �;��— <br /> Refund by Check No. Date <br /> _Original Receipt Attached <br /> Account Debited: <br /> Or refund noted on Treasurer's Office Copy. <br /> C � <br />