2016-11-07_REPORT - M2000118

• Permit No: M2000118
• IBM Index Class Name: REPORT
• Doc Date: 11/7/2016
• Doc Name: Annual Fee/Report/Map
• From: Pino Pit
• To: DRMS
• Annual Report Year: 2016
• Email Name: MAC
• Media Type: D
• Archive: No

CHECK REQUEST FORM
Date of Request /,Z
Date Needed 16r ?S /7 2
Mail wiattached Return to
APC CONSTRUCTION CO.
To Accounts Payable Department, please issue a check as follows-
PAYEE: U6 Lo ' �� �; Lv ° e9�«'►� n� '� c
ADDRESS 1:
ADDRESS 2:
CITY, STATE, ZIP CODE:
AMOUNT OF CHECK: REQUESTED B c
PURPOSE OF CHECK: `-i, — Ap,n u';" V.e
FOR ACCOUNTING USE ONLY: VENDOR NO.: APPROVED BY:
Acct: 6145-0000 Amount: $0.00 Acct: Amount: Acct. Amount.