HomeMy WebLinkAbout305932 9Jy i' CITY OF CARMEL, INDIANA VENDOR: 371292 CHECK AMOUNT: $...""'"300.00•
{ ONE CIVIC SQUARE KELLY CHENG
s ..�: CARMEL, INDIANA 46032 11620 PEBBLEPOINTE PASS CHECK NUMBER: 305932
� CARMEL IN 46033 CHECK DATE: 12/12/16
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
250 4350900 300.00 OTHER CONT SERVICES
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RESIDENTIAL COST-SHARE APPLICATION
of cjkj�
r CITY OF CARMEL STORM WATER USER FEE
RESIDENTIAL COST-SHARE APPLICATION lri.:r
APPLICATION TYPE: _Initial Application Installation Verification
APPLICANT NAME: APPLICANT PHONE NUMBER:
Kelly Cheng 317-590-5521
APPLICANT EMAIL ADDRESS: APPLICANT MAILING ADDRESS:
ethanrayliao@gmail.com 11620 Pebblepointe Pass, Carmel, IN
46033
PROPERTY ADDRESS: 11620 Pebblepointe Pass, Carmel, IN 46033
PROPERTY UTILITY ACCOUNT NUMBER: PROPERTY PARCEL NUMBER:
0311869103 16-10-33-00-08-043.000
COST-SHARE APPLYING FOR:
Rain Barrel Rain Garden
Permeable Surface _Other approved BMP's
RIGHT OF ENTRY
Upon approval of this application,the applicant agrees to give the City of Carmel and authorized
representatives the right to enter the premises without hindrances,and inspect any practice being
installed,or that has been installed,to receive a storm water utility credit. Denial of this right will result in
the loss of the storm water credit. Applicant's Initials K.C.
APPLICANT SIGNATURE: DATE:
10/25/2016
21
Submit application and attachments to: City of Carmel
Engineering Department
Attn: Department of Storm water Management
One Civic Square
Carmel, IN 46032
stormwoter@carmel.in.gov
Required attachments for the Residential Cost-share Incentive
INITIAL APPLICATION ATTACHMENTS INSTALLATION VERIFICATION ATTACHMENTS
Sketch of Site and Location of BMP(s) Photos of Installation
Photos of Site Receipts
_Application Fee
For Department of Storm water Management Use
APPLICANT NAME: PROPERTY ADDRESS:
DATE RECEIVED: RECEIVED BY:
/ o/
25'/
TARGET AREA: APPROVED
COOL CREEK WATERSHED OST-SHARE AMOUNT *"/ 2 00
REIMBURSEMENT SENT
DENIED(Reason)
STAFF SIGNAT DATE:
22
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10/272016 Gmidl-Your Order Is On Its Way I Order W498337883
M1. Shipping Confirmation
Appliances Bath Lighting Fans Flooring Tools&Hardware
Hi Kelly,
Your Order Has Shippedl
Please note that if you've ordered multiple products, they may be shipped separately.
Shipping Details Order Details
11620 Pebblepointe Pass Order No: W498337883
CARMEL , IN 46033 Order Date: 06/11/2016
Shipping Date: 06/13/2016 Carrier: UPS
Tracking Number(s):
1ZXlWO020340215006
Product Qty Qty Unit Total
Ordered Shipped Price
RainStation 45 Gal. Recycled 4 4 $98.98 $395.92
Black Rain Barrel with Diverter
Internet#: 203260850
UPC Code: 854472002174
Return Policy: A
Subtotal $395.92
Promotional Discounts -$76.36
Shipping $0.00
Estimated Sales Tax $22.37
Order Total $341.93
Payment Amount
XXXXXXXXXXXX3346 VISA $341.93
Return Policy Code Definitions
Policy 1D Days Policy Expires On
A 1 90 09/11/2016
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10127/2016 Gmail-Your Order Is On Its Way I Order W498337883
Returns Associate Instructions 111111111111111111111111
1.Scan/enter receipt barcode
2.Scan/enter item UPC 061368566468119
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