ENVH REFUNDHarnett
COUNTY
NORTH CAROLINA
Account Number:
Project Number:
Vendor Name:
Vendor Number:
Remittance Address:
Date 9-16-15
COUNTY OF HARNETT
CHECK REQUEST FORM
110-0000-345.18-00
Daniel Foucher
7421 Pine Summit Drive
Fuquay Varina, NC 27526
FX Mail to payee
Check to be picked up by:
(Requires approval of Finance Officer)
Approved: _ Disapproved:
Reason for check request: Fee being refunded at request of applicant. They will not be building on this lot.
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 O
This i6w1ment has been
preaudited 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
Application # 15-5-37061
Property location: 3166 Hillmon Grove Rd
Total Amount Due
Is 750.00
Reason for check request: Fee being refunded at request of applicant. They will not be building on this lot.
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 O
This i6w1ment has been
preaudited in the manner required
by the Local Government Budget
and Fiscal Control Act
Harnett County Finance Director