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� <br /> REFUND AUTHORIZATION <br /> T0: City Treasurer Date 4-2-96 <br /> You are hereby authorized to refund the following: <br /> PAYEE: D.I. Homea <br /> ADDRESS: 21127 State Rt 9 SE <br /> Woodinville WA 98072 <br /> AMOUNT: S 691.20 <br /> REASON: _ Cancelled permit to be replaced with different house plan <br /> CUSTOMER <br /> ! ACCOUNT # see attached <br /> � <br /> This amount was received by the City of Everett on 1-29-96 and recorded on <br /> permit or receipt number c5o3o4 (datel <br /> � <br /> 4-2-96 � <br /> fdetU (Authorizad Sfpnamre) <br /> Tim Tyler, Building Official <br /> (Titlal <br /> Refund by Check No. Date <br /> _ Original Receipt Attached <br /> Account Debited: <br /> Or refund noted on Treasurer's Office Copy <br />