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' , � : <br />� <br />� <br />T0: City Treasurer <br />You are hereby authorized to <br />PAYEE: <br />REFUND AUTHORIZATICN <br />the following: <br />ADDRESS: `�%� 77 � � yJi c�' <br />AMOUNT: S _5"'S. nG� <br />REASON: lV�A�La� c�,� � Lt�Ji c,e._. -�z��- <br />��� �7 � i5< /9�'i7 <br />. <br />Date /O -i.S - �l'/% <br />CUSTOMER <br />ACCOUNT # UO.� .3�.�- i� �'� ,�3/ <br />This amount was received by the City of Everett on i0 -•7- j7 and recorded on <br />J ce.ce� <br />permit or receipt number C-� Cc lC:.� <br />�o - i5- 9 7 <br />(deul <br />Refund by Check No. <br />_ Original Receipt Attached <br />Account Debited: <br />Or refund noted on Treasurer's Office Copy <br />Date <br />s�o�.c��.� <br />(Titlal <br />a <br />