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HomeMy WebLinkAboutEHPR-11-2022-42797.TIF catawba county public health AUTHORIZATION OF REFUND Date: 11/28/22 Case#: EHPR-11-2022-42797 Applicant: Silvino Reyes Leal Refund Amount: S300 Refund Reason: application EHPR-11-2022-42797 withdrawn r� Authorizing Signature: i t�,�/ Received By Staff: 1 Gi, 1,a-fp() Date: � �81J3 catawbacountync.gov Environmental Health Co►cwbo County Government Center 25 Government Drive I PO Box 389 I Newton NC 28658 1828.465.8270 MAKING. LIVING. BETTER. Catawba County, North Carolina - Disbursement Voucher Vendor No. Date: 11/28/2022 Make Payment To: �4 ____ Voucher No(s) Silvino Reyes Leal 4372 Morning Dr ti Claremont, NC 28610 v Ig42 ATTACHMENT Prepared by: Julia English Description Amount Application EHPR-11-2022-42797 withdrawn $300.00 Sub-Total Food Tax Sales Tax Total $ 300.00 For Accounting Use Fund Cost Center Object Project Amount Only 110 580200 663000 Total The undersigned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) �$A • CATAWBA COUNTY ��' l G 100A SOUTHWEST BLVD NEWTON,NORTH CAROLINA 28658 RECEIPT U79 0 PHONE:828.465.8399 Monday, November 28,2022 8 4 2 5M www.catawbacountync.gov PAYOR: Reyes Leal,Silvino PAYMENTS TRANSACTION NUMBER: TRC-52 1 46093-28-1 1-2022 PAYMENT DATE: 11/28/2022 PAYMENT TYPE: DV INVOICE NUMBER ACCOUNT FEE NAME FEE AMOUNT 11-22-414856 110-580200-663000 Authorization to Construct(Repair) (S300.00) Fee TOTAL PAYMENTS: ($300.00) EH PR-1 1-2022-42797 CASE TYPE: Environmental I lealth Plan Review WORK CLASS: Septic Malfunction SITE ADDRESS: 4372 MORNING DR,CLAREMONT NC 28610 Owner SILVINO REYES LEAL,4372 MORNING DR,CLAREMONT NC 28610 C:8287815605 **NO PEOPLESOFT ACCOUNT ASSIGNED** receipt 11/28/2022 14:29 Page 1 of 1