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everett <br />To: <br />City Tre&Surer <br />REFUND AUTHORIZATION <br />Da to cT <br />you are hereby authorized to refund the following: <br />Address:vy-(�l�G <br />Ar:oun t : <br />Doscription:����L/gyp <br />Customer <br />Account No. <br />This amount was received by the City of Everett on <br />19- <br />and recorded on City Treasurer's Receipt No. — <br />City ermit No,A�L <br />Z has been returned/cancelled. <br />/�D ILCP <br />I Plaas have beer. returned to this department. <br />A charge has been made to the 4Authot- <br />'s account for this refund. <br />/;) - s 73-- <br />- ized ign' ireDate <br />'title <br />------------------------------------- <br />Date 19 Original Receipt <br />Refund by Check No. -- Attached <br />Account Debited: Lund Basub Elem Util Obj or <br />Refund Noted on <br />Treasurer's <br />Office Cnnv <br />