HomeMy WebLinkAboutBryant Lowman App 610189 02 01 16.TIF itom" ` r . i - .gaSI*� i"K r ka� .. or .rx ii �' i �� Z I' ` ` "' v
e Cattawba County,North„s?arolina; Disburrsemennt Vout her , o"
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Vendor No. Date 02/22/16
Make Payment To: .:�A s(0 Voucher No(s).
Dream Salon - Rita Fair
2404 A. North Center St. Q �i►�
Hickory NC 28601 g4
ATTACHMENT
Prepared by: Katherine Harris
Description Amount
Tattoo Artist Permit Fee 225.00
Sub-Total $ 225.00
Food Tax
Sales Tax
Total $ 225.00
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The undersigned hereby certifies that the goods or services specified above have been received
or performed. Payment has not been previously authorized and this expenditure is a proper
charge to the appropriation indicated. The above charge is certified to you for payment.
(S IGNATUR -APPROPRIATE OFFICIAL)
cArrAi, Environmental Health - Division of Public Health
COUNTY .;41,. .•� PO Box 389—100-A South West Blvd. - Newton, North Carolina 28658
J�4, >*;: (828)465-8270—Fax(828)465-8276
North earolIna NS'vv'wi'.catawhacounhnc.LON env ironmentalhealth/
AUTHORIZATION OF REFUND
Date: 2/22/16
Case#: FLI-10-2015-066158
Applicant: Bryant Lowman Paid By: Rita Fair/Dream Salon
Refund Amount: S225.00
Refund Reason: Permit was not issued. Artist will not be at this location.
Authorizing Signature: ?Sit)
Received By Staff:
Date: 212:5\\kto
r "Leading the Way a Healthier Community
Mif tyz m ii i la)
" ��, y,3/ Public Health
C'"�p'A � � CATAWBA COUNTY
I OOA SOUTHWEST BLVD
NEWTON, NORTH CAROLINA 28658 RECEIPT PHONE: 828.465.8399
C. `1 ®6A) �C Monday, February 22, 2016
/842 sns www.catawbacountync.gov
PAYOR:
Dream Salon (Fair, Rita)
PAYMENTS
TRANSACTION NUMBER: TRC-625482-22-02-2016
PAYMENT DATE 02/22/2016
PAYMENT TYPE: DV
INVOICE NUMBER FEE NAME FEE AMOUNT
10-15-322371 Tattoo Artist Fee (S225.00)
TOTAL PAYMENTS : ($225.00)
FLI-10-2015-066158
CASE TYPE: Food & Lodging Institutions WORK CLASS: 61 -Tattoo Artists
SITE ADDRESS: 1312 H W Y 70 SW, HICKORY NC 28602
Applicant BRYANT LOWMAN, 5470 ERMA LAIL LN, GRANITE FALLS NC 28630
H:8288965690
** NO PEOPLESOFT ACCOUNT ASSIGNED **
Paid By DREAM SALON,2404 N CENTER ST, HICKORY NC 28601
C:8288553999 DREAMSALON4EVER@GMAIL.COM
receipt 02/22/2016 14 35 Page I of I