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4-1577 <br /> REFUND AUTHORIZATION <br /> TO: City Treasurer Date -/ "97 <br /> You are hereby authorized to refund the following:/C <br /> PAYEE: y� C6 Y/� nZA-J L <br /> ADDRESS: �� Yi3 ACX <br /> zk lw rl'�Oi 2 <br /> AMOUNT: $ 70/J, 02 <br /> REASON: �1 �_rnJ✓h �� 5�7�'7✓ <br /> CUSTOMER <br /> ACCOUNT # <br /> This amount was received by the City of Everett on y-9 7 7 _ and recorded on <br /> (date) <br /> permit or receipt number / ��5�7�:J <br /> (date) (Authorized Signature) <br /> (r1dal <br /> Refund by Check No. Date _ <br /> Original Receipt Attached <br /> Account Debited: <br /> Or refund noted on Treasurer's Office Copy <br />