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��..� <br />'�� <br />REFUND AUTHORIZATION <br />T0: City Treasurer <br />Date izi2�/9s <br />You are hereby authorized to refuncl the following: <br />PAYEE: Teff S hro her <br />ADDRESS: 420 Mor�a� Rd <br />AMOUNT: <br />REASON: <br />��iXTl�7�i�i'I:Ylik <br />� <br />__ nwner d�d d o ontract out electrical work - 80% refund <br />CUSTOMER <br />ACGOUNT# no -� -i2oo-s�i <br />This amount was received by the City of Everett on _ iv26i9s and recorded on <br />ldetel <br />permit or receipt number F5n�9i <br />(data) <br />(Authorized Sipneture) <br />ITitle) <br />Refund by Check No. <br />_ Original Receipt Attached <br />Account Debited: <br />_ Date <br />Or refund noted on Treasurer's Office Copy � <br />