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14050080 Receipt/Permit
CITY OF CARMEL 4 ITEMS OF 4 PERMIT RECEIPT OPERATOR: plux COPY # : 1 Sec.:25 Twp: 18 Rng:3 Sub:COB Blk: Lot :l PARCEL ID . . . . . . . . : 1609250806001000 DATE ISSUED. . . . . . . : O5/14/2014 RECEIPT # . . . . . . . . . : BC000007601 REFERENCE ID # . . . : 14050079 SITE ADDRESS . . . . . : 774 1ST AVE NW SUBDIVISION . . . . . . : COBBLESTONE COMMONS CITY . . . . . . . . . . . . . : CARMEL I�MPACT AREA� . .. . . . . . OWNER. . . . . . . . . . . . . : DENNERLINE, RICHARD AND ANN ADDRESS . . . . . . . . . . : 774 1ST AVE NW CITY/STATE/ZIP . . . : CARMEL, IN 46-032 RECEIVED FROM . . . . : OLD TOWN DESIGN GRO CONTRACTOR . . . . . . . : (FORMERLY MADDOX EXCAVATING) LIC # XELEVEXC COMPANY . . . . . . . . . . : ELEVATION EXCAVATION INC ADDRESS . . . . . . . . . �. : 1132 RANGE LINE RD S CITY/STATE/ZIP . . . : CARMEL, IN 4�6032 TELEPHONE . . . . . . . . : (317) 816-3149 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT� THIS REC NEW BAL -------- ----------- ---- ----- ----- USEWERINSP FLAT RATE 1 . 00 102 . 00 0 . 00 102 . 00 0 . 00 USFSEWCONN FLAT RATE 1 . 00 1498 . 00 0 . 00 1498 . 00 0 . 00 USFWATCONN FLAT RATE 1 . 00 2.615 . 00 0 . 00 2615 . 00 0 . 00 UWATERTAP FLAT RATE 1 . 00 102 . 00 0 . 00 102 . 00 0 . 00 TOTAL PERMIT : 4317 . 00 0 . 00 4317 . 00 0 . 00 METHOD OF PAYMENT AMOUNT REFERENCE NiJMBER --------------- -------- - CHECK 4 , 31'I . 00 3607 TOTAL RECEIPT : 4 , 317 . 00