ENVH REFUNDNORTf� CAROLINA
Account Number:
Project Number:
Vendor Name:
Vendor Number:
Remittance Address
Date 4 -03 -14
A • • • •
110 - 0000 - 345.18 -00
Justin Diebold
125 Anna Drive
Clayton, NC 27520
❑—x ]Mail to payee
FI Check to be picked up by:
(Requires approval of Finance Officer)
Approved: Disapproved:
Reason for check request: Justin Diebold with Clearwater Pools called to request a refund. Customer will
proceed at a later date for an 18x36 pool. No inspection was ever scheduled.
This check request has been examined by me and is hereby approved for payment.
Department Head or u fiorized Designee Date
Graham H. Byrd, R.E.H.S. -�"" r
TN tru ent has been
preaudited in the manner required
by the Local Government Budget
and Fiscal Control Act
Harnett County Finance Director
Description
Amount
Existing Tank Fee
$ 100.00
Application #14 -5 -33193
Location: 160 Kimbrough Dr. Woodshire Lt 192
Total Amount Due
1 $ 100.00
Reason for check request: Justin Diebold with Clearwater Pools called to request a refund. Customer will
proceed at a later date for an 18x36 pool. No inspection was ever scheduled.
This check request has been examined by me and is hereby approved for payment.
Department Head or u fiorized Designee Date
Graham H. Byrd, R.E.H.S. -�"" r
TN tru ent has been
preaudited in the manner required
by the Local Government Budget
and Fiscal Control Act
Harnett County Finance Director
BP821U01
Application number . :
Address . . . . . . :
Position to . . . . .
Type options, p
1= Select
Amount
Opt To Apply
_ 00
_ 25.00
_ .00
_ 25.00
_ .00
10.00
75.00
3.00
100.00
Harnett County
Application Fees Maintenance
14 50033193
160 KIMBROUGH DR
ress Enter.
Description
_ CP* MISCELLANEOUS
_ ENVIRON HLTH REVISION FEE
_ EV* REINSPECTION FEE
EV *RETURN TRIP FOR SEPTIC
EXIST. TANK TEST /INSP.
_ HOMEOWNER RECOVERY FUND
_ LAND USE RENEWAL
_ MAIL -IN PROCESSING FEE
PZ FLOOD PERMIT
F3 =Exit F9= Display all F12 =Cancel
4/03/14
15:30:02
01
Starting characters
Previously
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Paid Inactive
.00
.00
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.00
.00
.00
.00
.00
100. -00_
100.00
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.00
.00
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.00
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