ENVH RefundHarnett
COUNTY
FORTH CAROLINA
Account Number:
Project Number:
Vendor Name:
Vendor Number:
COUNTY F HARNETT
CHECK REQUEST FOR
110-0000-345.18-00
Raymond Lasso
F ]Mail to payee
F]Check to be picked up by:
(Requires approval of Finance Officer)
Remittance Address: 1233 Aspen Meadow Lane
Date: December 5, 2011 Cary, NC 27518
Approved: Disapproved:
Description
Amount
Environmental Health Soil Evaluation Fee
$ 750.00
Application #11-5-27990
Regal Crest S/D Lot 3
Total Amount Due
$ 750.00
Reason for check request: Customer called and stated that due to an emergency in family, he would like a refund.
No site visit. Application just received on December 5, 2011. Will re-apply at a later date.
This check request has been examined by me and is hereby approved for payment.
Department Head or uthori ed Designee
Graham H. Byrd, R.E.H. . r}!/ - <5,
ns ument has been
preaudited in the manner required
by the Local Government Budget
and Fiscal Control Act
Date
Harnett County Finance Director