ENVH RefundNORTH' CAKOLINA
Account Number: 110-0000-345.18-00 - EH
Project Number:
Vendor Name:
Vendor Number:
Remittance Address:
Date 8-24-15
Joseph E. Nutt, Jr.
2080 Nursery Road
Lillington, NC 27546
❑X Mail to payee
Check to be picked up by:
(Requires approval of Finance Officer)
Approved: Disapproved:
Reason for check request: Customer decided to back out of the purchase.
This check request has been examined by me and is hereby approved for payment.
Department Head or Authorized Designee Date
Graham H. Byrd, R.E.H.S.
his instrument has been
preaudited in the manner required
by the Local Government Budget
and Fiscal Control Act
Harnett County Finance Director
Description
Amount
ENVH Existing Tank Fee
$ 100.00
Application # 15-5-36874
Location: 5965 Old US 421
Total Amount Due
$ 100.00
Reason for check request: Customer decided to back out of the purchase.
This check request has been examined by me and is hereby approved for payment.
Department Head or Authorized Designee Date
Graham H. Byrd, R.E.H.S.
his instrument has been
preaudited in the manner required
by the Local Government Budget
and Fiscal Control Act
Harnett County Finance Director