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0 <br />everett <br />\ / <br />REFUND AUTFIORIZATION <br />To: City Treasurer Date <br />You are hereby authorized to refund the following: <br />Payee: <br />Address: <br />Amount <br />Reasun: <br />Customer <br />Account No. <br />Scott/Herald Emulovee Family 'iervice Assc <br />c/o Darrell Moffitt <br />87 N Sunrise Blvd <br />Camano Island WA _Zip 9gZgz <br />$ 29.15 <br />Check written for too much <br />This amount was received by the City oE Everett �n 7-20 <br />and recorded on City Treasurer's Receipt No. <br />19 94 <br />❑ City bldg Permit No. 44531 has been returned/cancelled. <br />❑ Plans have been returned to this department. <br />❑ A charge has been made to the customer's account for this refund. <br />7-21-94 <br />Date ' A t iorize Signature <br />Building Official <br />Tit e <br />---------------------------------------------------------------- <br />Refund by Check No. Date 19 Original Receipt <br />Attached <br />Account Debited: Fund Basub Elem Util Obj <br />002-3221101831 <br />`_ or <br />Refund Noted <br />, , on Treasurer's <br />Office Copy <br />