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CITY OF EVERETT <br />REFUND AUTHORIZATION <br />TO: City Treasurer DATE January 5_2010 <br />You are hereby authorized to refund the following: <br />PAYEE <br />Camden Coyrt LLC <br />8 <br />3726 BrosfAway #301 <br />ADDRESS: <br />Everett, WA 98201 <br />AMOUNT: $ 1409.08 <br />REASON. New buyer wanted a smaller home <br />GL CODE: 002-322-1101-831: $1225.08 <br />002-322-1500-831: $72.00 <br />002-322-1300-831: $112.00 <br />These amounts were received by the City of Everett on December 3, 2009, and recorded on permit number <br />C0912-002. <br />January 5, 2010 <br />(date) (Authorized Signature <br />Kirk Brooks -Building Official <br />e <br />Refund by Check No. Date <br />Original Receipt Attached <br />Account Debited: <br />Or refund noted on Treasurer's Office Copy. <br />