RefundDOCUMENTFOR SECURITY PURPOSES THE FACE OF THIS
AMERICANA
CITY OF CHANHASSEN COMMUNITY BANK 180912
7700 MARKET BLVD., P.O. BOX 147 CHANHASSEN, MN 55317
CHANHASSEN, MN 55317 75-196-919
(952) 227-1140
Pay TWO HUNDRED AND XX / 100
Date Amount
To the order of 7/3/2024 $200.00
Gerald Story
6281 Teton Lane p
Chanhassen, MN 55317j(�%���
11, 1809 L 2115 1:09 L90 L9691: 30 231 L61I@
Check Date: 07/03/2024 Vendor No: StorGera
Check Amount: 200.00 Vendor Name: Gerald Story
Vendor Acct No:
Invoice Number Date Description Amount
Inv00607812 07/02/2024 Appeal Refund-6251 Teton Lane 200.00
VAR 24-07