ENVH REFUNDHarnett
COUNTY
NORTH CAROLINA
Account Number:
Project Number:
Vendor Name:
Vendor Number:
Remittance Address:
Date 4-6-17
COUNTY OF HARNETT
CHECK REQUEST FORM
110-0000-345.18-00
Ann Maynor
75 Bryson Court
Apt. 101
Lillington, NC 27546
FX Mail to payee
Check to be picked up by:
(Requires approval of Finance Officer)
Approved:_ Disapproved:_
Reason for check request:
Problems with lot and missing information therefore applicant requested refund.
Site was evaluated by Oliver Tolksdorf and confirmed it was ok to refund money.
This check request has been examined by me and is hereby approved for payment.
Department Head or Authorized Des'g ee Date
Graham H. Byrd, R.E.H.S.4�%'
its instrument ha
preoudited in the manner required
by the Local Government Budget
and Fiscal Control Act
Harnett County Finance Director
Description
Amount
ENVH Soil Evaluation Fee
$ 750.00
Location: Ray Byrd Road
Stockyard Estates Lt 45
HTE # 16-5-39578
Total Amount Due
$ 750.00
Reason for check request:
Problems with lot and missing information therefore applicant requested refund.
Site was evaluated by Oliver Tolksdorf and confirmed it was ok to refund money.
This check request has been examined by me and is hereby approved for payment.
Department Head or Authorized Des'g ee Date
Graham H. Byrd, R.E.H.S.4�%'
its instrument ha
preoudited in the manner required
by the Local Government Budget
and Fiscal Control Act
Harnett County Finance Director