HomeMy WebLinkAboutFLI-04-2023-193604.TIF catawba county
public health
AUTHORIZATION OF REFUND
Date: 9/1/2023
Case It: FLI-04-2023-193604
Applicant: Derek VanCleve
Refund Amount: S225.00
Refund Reason: Artist Danny Rice no longer working
Authorizing Signature: r---
Received By Staff: 4 4IV
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Date:
catawbacountync.gov
Environmental Health
Catawba 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: 9/1/2023
Make Payment To: ��wO Voucher No(s)
Derek VanCleve Q' t t 1�7762 Lake Haven Dr <4 rA
Denver, NC 28037 v ir7 .i167 `�
ATTACHMENT
Prepared by: Julia English
Description Amount
FLI-04-2023-193604 Artist Danny Rice no longer working $225.00
Sub-Total
Food Tax
Sales Tax
Total $ 225.00
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)
#.ftdCATAWBA COUNTY
, 1 00A SOUTHWEST BLVD
NEWTON,NORTH CAROLINA 28658 RECEIPT
V . PHONE:828.465.8399
Friday,September 1,2023
1$42 sM www.catawbacountync.gov
PAYOR:
VanCleve,Derek
PAYMENTS
TRANSACTION NUMBER: TRC-72168263-01-09-2023
PAYMENT DATE: 09/01/2023
PAYMENT TYPE: DV
INVOICE NUMBER ACCOUNT FEE NAME FEE AMOUNT
04-23-421841 110-580200-663000 Tattoo Artist Fee ($225.00)
TOTAL PAYMENTS: ($225.00)
FLI-04-2023-193604
CASE TYPE: Food&Lodging Institutions WORK CLASS: 61 -Tattoo Artists
SITE ADDRESS: 724 1ST AVE SW,HICKORY NC 28602
Applicant DANNY RICE,304 CATTLEMAN'S RD,STATESVILLE NC 28265
C:9802466594
Paid By DEREK VANCLEVE,7662 LAKEHAVEN DR,DENVER NC 28037
C:7276141042
**NO PEOPLESOFT ACCOUNT ASSIGNED**
receipt 09/01/2023 12:39 Page 1 of 1