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CITY OF EVERETT <br /> REFUND AUTHORIZATION <br /> TO: City Treasurer DATE: July 20, 2016 <br /> You are hereby authorized to refund the following: <br /> PAYEE Acme Homes LLC <br /> & 10211 180th St SE <br /> ADDRESS: Snohomish WA 98290 <br /> C o py <br /> AMOUNT: $ 2584.00 <br /> REASON: °Contractor is requesting a refund, as the work is not going to take place; these address <br /> did not qualify for the city's backwater valve program. <br /> GL CODE: 002-322-1101-831: <br /> 002-322-1500-831: Permits U1604-019—original fees paid <br /> 002-322-1300-831: $2584.00; 100 % refund due to error on <br /> 002-322-1200-831: original permitting, corrected with new <br /> 002-322-4011-831: <br /> 401-343-50-109-460-00: $ 70.00 permit. <br /> 401-343-40-119-471-02: $2514.00 <br /> 002-345-8300-831: <br /> 002-369-8101-000: <br /> 157-345-8601-000: <br /> Payment was made with CREDIT CARD to the City of Everett on 04/14/2016 and recorded on permit. <br /> July 20, 2016 <br /> Ili <br /> (date) ( u horized Signature) <br /> Paul McKee <br /> (Title) <br /> Refund by Check Date <br /> • <br /> Original Receipt Attached <br />