ENVH Existing Tank RefundHarnett
COUNTY
NORTH CAROLINA
Account Number:
Project Number:
Vendor Name:
Vendor Number:
Remittance Address:
Date 7-28-11
COUNTY OF HARNETT
CHECK REQUEST FORM
110-0000-345.18-00 F-x]Mail to payee
F]Check to be picked up by:
Justin Haynes
246 Marvin Ferguson Drive
Lillington, NC 27546
(Requires approval of Finance Officer)
Approved: Disapproved:
Description
Amount
Environmental Health Existing Tank Fee
$ 100.00
Application # # 11-5-27037R
Site: Mamie Bell Ridge S/D Lt 45
Total Amount Due
$ 100.00
Reason for check request: Per James Manhart, applicant decided that due to the cost of expansion to septic
system (in order to change home from 3 bedrooms to 4) he would not proceed with
original request. Revised application received to reflect these changes. Environmental
Health owes a refund of $100.00 for the existing tank inspection.
This check request has been examined by me and is hereby approved for payment.
-"Mali"
Graham H. Byrd, R.E.H.S._
This instrument has been
preoudited in the manner required
by the Local Government Budget
and Fiscal Control Act
Harnett County Finance Director