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��� <br />��x <br />Q H <br />9Hy <br />rxa <br />y5N <br />K n <br />H� <br />�H�1 <br />V1 H <br />Kl O � <br />H <br />OM <br />H�g <br />�] V �❑] <br />YHC+7 <br />t" z <br />HH <br />g�' <br />� <br />��� <br />�HN <br />HOtn <br />everett <br />REFUND AUTHORIZATION <br />To: City Treasurer <br />Date 2-7-9z <br />You are hereby auchorized to refund the folloving: <br />Peyee: 9i�ex Z�a cinic/i �aodLi% Cor�f%� <br />Address: .Ss�/O - S �'t��✓c. <br />Fver� �, wG. Zip �20 <br />pmount: $ 9G�oo � -�- <br />Reaeon: T.^/�b�me.,c•� Q�4rn.s7�c� �a� <br />v <br />ff2•¢7{Gn��'/CL.e�/ /�n�o�o.✓e.•vc-�7'�S <br />� <br />Cuetomer <br />Account No, <br />Thie amount vaa received by the City of Everet[ on 7 � 9 19 /� <br />aad recorded on Clty Treaeurer's Receipt No. 5���`� <br />� <br />� <br />� <br />fubCi o <br />City tdn��CS Permit No.9�'�7�hae been returned cancelled. <br />Plane have been returned to [hie department. <br />A charge hae been made to the cuseomer's account for thla refuad, <br />� ' � <br />'�? -7-9z > a/�c,��icr.� <br />� Date Authorized Signature <br />�1 l <br />lJ�ut�ixn� 7` .��t�i <br />� Title <br />'---""-' -"-----'--'-"--""'--"'--'-----"--' -'-'---' -"'-'-"'------"----'------ -----'---- --' <br />Refund by Check No. Date 19_ <br />Account Debited: Fund Baeu6 Elem Uti1 ObJ <br />� w � w <br />L � � W � � W <br />or <br />Orlginal Receipt <br />Attached <br />ReEund Noted on <br />Treasuter's <br />Office Copy <br />