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eve; ett <br />REFUND AUTHORIZATION <br />To: City Treasurer <br />w«. <br />ONO N§ �r <br />JUL 3 J 19I3 'O <br />CITE _ <br />Date <br />You are hereby authorized to refund the following: <br />Payee: PC IL56- 7- v✓ ��,✓✓s',p <br />Address: 3y-1 7 OrAir*s <br />Amount: Sy/S' <br />Description: 1�c4xo cG AO�US n rv— a �p cr rum <br />Customer <br />Account No. <br />This amount was received by the gity of Everett on .ram — / 7 19 7 3; <br />and recor6ed on City Treasurer's Receipt No. 2 7,;I y.? <br />City Permit No. _ has been returned/cancelled. <br />U Plans have been returned to this department. <br />I—J A charge has been made to the customer's account for this refund. <br />Date Authorized Signature <br />-------------- ----- TiL1 <br />----------------------------------------------------------- <br />Refund by Check No. C/3 Date 197_3 p/Original Receipt <br />Attached <br />Account Debited: Fund Basub E-llelm Util Obj <br />or <br />Refund Noted on <br />Treasurer's <br />Office Copy <br />