HomeMy WebLinkAbout308311 02/13/17 CITY OF CARMEL, INDIANA VENDOR: 366545
ONE CIVIC SQUARE OLD TOWN DESIGN GROUP
(9,
CHECKAMOUNT: $****13,404.00*
CARMEL, INDIANA 46032 1132 RANGELINE ROAD CHECK NUMBER: 308311
CARMEL IN 46032 CHECK DATE: 02/13/17
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
101 5023990 13,404.00 OTHER EXPENSES
VOUCHER NO. WARRANT NO.
ALLOWED 20
IN SUM OF $
CA2
ON ACCOUNT OF APPROPRIATION FOR
Board Members
Po#or INVOICE NO. ACCT#/TITLE AMOUNT
DEPT.# I hereby certify that the attached invoice(s), or
So�39�o i3, d g bill(s) is (are) true and correct and that the
(�0\ materials or services itemized thereon for
which charge is made were ordered and
received except
20
IS ilrk e
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund
•i i.♦i�l v t L 1�L�/ `1 LV 1 L LLLJ L VL\LVL L V. j
Bulldin��z Code services City of Carmel
�'�,•, ` o Building&r Code Services
Cr�i,c;rr„a+iil�n: Ph. (317) 571-2444 Fax(317) 571-2499
�r '
One Civic Square;
ioIApka.
- Carmel, [:.1 46032
PERMIT #(s): ILDO -5 001Z. Z,('V` .
Lot & Subdivision, or Address of Construction: l,P�2.o �CJrj
3 �.
(If more than one address needs to be list d and will not fit, ple se attach a printed list of all permits,with
their corresponding permit#.)
Please print or type the reason for the requested refund, and specific fee or fees M M6X
which are requested, in the lines below:
I/RI
UZ34,0
TOTAL REFUND AiIMOUNT REQUESTED:
App cant-Sign ture Date
)4ish --Dec,:�nn C-mtfi)
Ap licant Name—Printed Company Nam ( applicable)
APPLICANT ADDRESS:
1 �z % n
Street Address
l -7W �o3z
City.. ST Zip
Phone# Fax#
:OR OFFICE USE ONLY:
Total amount for fees that ARE available for refund: ` ' I �r-N
T-
e
+ Fees that are NOT available for refund: 9t
Refund approved by:` Date:
Date submitted for Payment: :17 _ Amount Approved: