HomeMy WebLinkAboutEHPR-06-2022-41351.TIF 411111A1
catawba county
public health
AUTHORIZATION OF REFUND
Date: 8/1/2022
Case#: EHPR-06-2022-41351
Applicant: Bryant Shipton—Oxford Baptist Church
Refund Amount: $580.00
Refund Reason: Refund all by $70. Problem corrected. No permit needed.
Authorizing Signature: v.\\uf--;
Received By Staff: foititiL tC t '
Date: ' c6 1' I Z
catawbacountync.gov
Environmental Health
Ccicwhc County Government Center
25 Government Drive I PO Box 389 18ewton NC 28658 1828.465.827C
Catawba County, North Carolina - Disbursement Voucher
Vendor No. Date: 8/1/2022
Make Payment To: ��P Cps Voucher No(s)
Bryant Shipton � t- t
Oxford Baptist Church Q 'aPA ►�
5965 Springs Rd ib7 47'
Conover, NC 28613 184'L
ATTACHMENT
Prepared by: Julia English
Description Amount
Refund all but$70. Problem corrected. No permit needed $580.00
Sub-Total
Food Tax
Sales Tax
Total $ 580.00
For Accounting Use
Fund Cost Center Object Project Amount Only
110 580200 663000
Total
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.
(SIGNATURE-APPROPRIATE OFFICIAL)
EA CATAWBA COUNTY
Ii�' 100A SOUTHWEST BLVD
NEWTON,NORTH CAROLINA 28658 RECEIPT
.1PHONE: 828.465.8399
Monday,August 1,2022
8 42 SM www.catawbacountync.gov
PAYOR: Oxford Baptist Church
Oxford Baptist Church(Shipton,Bryant)
PAYMENTS
TRANSACTION NUMBER: TRC-44494845-0 1-08-2022
PAYMENT DATE: 08/01/2022
PAYMENT TYPE: DV
INVOICE NUMBER ACCOUNT FEE NAME FEE AMOUNT
06-22-407724 110-580200-663000 Authorization to Construct Fee(N ($500.00)
ew/Expansion) Fee
06-22-407724 110-580200-663000 Improvement Permit Fee (S80.00)
TOTAL PAYMENTS: ($580.00)
EHPR-06-2022-4 1351
CASE TYPE: Environmental Health Plan Review WORK CLASS: Septic Malfunction
SITE ADDRESS: 5965 SPRINGS RD,CONOVER NC 28613
Contact Person *COOL PARK PUMPING,INC, 1535 VICTORIAN HILLS CIR,CONOVER NC 28613
11:8286327137B:8282562926C;828217I596F:828-256-2926 SAME AS PHONE 4ISENI IOUR`r,GMAIL.CO
Owner OXFORD BAPTIST CHURCH INC,5965 SPRINGS RD,CONOVER NC 28613
Paid By OXFORD BAPTIST CHURCI I,5965 SPRINGS RD,CONOVER NC 28613
C:7042233155
**NO PEOPLESOFT ACCOUNT ASSIGNED**
receipt 08/01/2022 12.51 Page 1 of 1