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1992, 10-30 Permit: 92007352 RefundVENDOR CODE REFUND SPOKANE COUNTY. PAYMENT VOUCHER 132004 10/30/92 NAME ALWAYS ACTIVE ADDRESS P. 0. BOX 141562 SPOKANE, WA 99214 DATE AGENCY NAME CODE ENFORCEMENT AUDITORS STAMP ACCOUNT DISTRIBUTION, ORIGINATING ENUTY"(AL VOUCHER TYPES) • 1099 REQ'D ID# LINE NO. ' VENDOR' INVOICE NUMBER FUND AGENCY ORGAN- IZATION ACT OBJ SUB OBJ REV SOURCE SUB REV JOB NUMBER REPT CATEG BS ACCT- DESCRIPTION AMOUNT 1 92-007352 401 436 0000 4241 REFUND 40.00 2 406 030 0008 221C 02 11 10.00 DETAIL DESCRIPTION 1 & 2 100% REFUND ON PERMIT N92-007352 FOR SEWER PERMIT FOR I, the undersigned do hereby certify under penalty of perjury TOTAL 50.00 13105 EAST CATALDO AVENUE DUPLICATE PERMIT PER COPIES that sufficient funds have been OF PERMITS ATTACHED budgeted for this claim, the ma- terials have been furnished, ser- vices rendered or labor performed as described herein or contracted for, that. the claim is a just, due and unpaid obligation against Spokane County or fund agency TRAVEL CERTIFICATION 1 hereby certify under penalty of perjury that this is a true and correct- claim for necessary expenses incurred by me and that no payment has been received by me on account thereof. SIGNED indicated above, that I am autho- rized to authenticate and certify TITLE INTRA -GOVERNMENTAL VOUCHER to said claim: DATE FUND AGENCY ORGAN- IZATION SUB ORG SELLERS ACTIVITY ACCOUNT REVENUE SOURCE. SUB REV DISTRIBUTION JOB NUMBER RPT.OFFSET CATEG. .R ACCOUNFS EXAMINED and ALLOWED CERTIFICATION DATE 19 N. SIGNED __ _3\ CHAIRMAN SELLER CERTIFICATION I, hereby certify that the materials have been furnished, the services SIGNED _ \ \\ TITLE FF LCE ADMINISTRATORS MEMBER rendered or the labor performed as described herein or contracted for, and that the claim is a just, due and unpaid obligation, and that TITLE 10/30/92 I am authorized to authenticate and certify to said claim. DATE DATE MEMBER