ENVH RefundHarnett
COUNTY
Account Number:
Project Number:
Vendor Name:
Vendor Number:
Remittance Address:
COUNTY OF HARNETT
CHECK REQUEST FORM
110-0000-345.18-00
Ashley Glover
F -x to payee
F-I Check to be picked up by:
(Requires approval of Finance officer)
206 Stewart Road
Approved: Disapproved:
Godwin, NC 28344
Description
Amount
ENVH Existing tank fee for proposed daycare
$ 100.00
located at 608 Spring Branch Rd, Dunn, NC
Ashely's Angels
Application # 10-5-25279
Total Amount Due
$ 100.00
Reason for check request: Applicant is applying for county sewer
This check request has been examined by me and is hereby approved for payment.
Department Head or Authorized Designee
This insturment has been
preoudited in the manner required
by the Local Government Budget
and Fiscal Control Act
Date
Harnett County Finance Director