HomeMy WebLinkAbout318285 11/7/2017 *, CITY OF CARMEL, INDIANA VENDOR: 372047
ONE CIVIC SQUARE MARGOT GIBSON CHECK AMOUNT: $**......75.00*
CARMEL, INDIANA 46032 13810 LAREDO DRIVE CHECK NUMBER: 318285
' CARMEL IN 46032 CHECK DATE: 11/07/17
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
250 4350900 75.00 OTHER CONT SERVICES
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RESIDENTIAL COST-SHARE APPLICATION
of Ca'.
CITY OF CARMEL STORM WATER USER FEE
RESIDENTIAL COST-SHARE APPLICATION aw
APPLICATION TYPE: _„_Initial Application _Installation Verification
APPLICANT NAME: APPLICANT PHONE NUMBER:
APPLICANT EMAIL ADDRESS: APPLICANT MAILING ADDRESS:
PROPERTY ADDRESS:
PROPERTY UTILITY ACCOUNT NUMBER: PROPERTY PARCEL NUMBER:
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COST-SHARE APPLYING FOR: - —— --
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Rain Barrel _Rain Garden
Permeable Surface _Other approved BMP's
RIGHT OF ENTRY
Gni LICK � 44-c . �t
Upon approval of this application,the applicant agrees to give the City of Carmel and authorized V
representatives the right to enter the premises without hindrances,and inspect any practice being
Installed,or that has been installed,to receive a storm w je�tility credit. Denial of this right will result in
the loss of the storm water credit. Applicant's Initials 1�' ti
APPLICANT SIGN Ttj DATE:
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Submit application and attachments to: City of Carmel
Engineering Department
Attn:Department of Storm water Management
One Civic Square
Carmel,IN 46032
stormwater@carmeLin.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: q1 w/ � RECEIVED BY:
TARGET AREA: XPPROVED
COOL CREEK WATERSHED XCOST-SHARE AMOUNT
REIMBURSEMENT SENT
DENIED(Reason)
STAFF SI UR DATE:
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RESIDENTIAL COST-SHARE INCENTIVE APPLICATION
APPLICATION TYPE:Indicate whether the application is an:
Initial Application —this application is to be submitted to Indicate the applicant's interest in
installing a rain barrel and/or a rain garden. All required attachments must be submitted to be
considered. Applicants are advised not to proceed until the Initial Application has been
approved by the City.
Installation Verification — once the rain barrel and/or rain garden have been installed, the
applicant must submit this application and all required attachments to be considered for the
cost-share reimbursement.
APPLICANT NAME: Name of person applying for the credit. This can be the property owner or person
acting on behalf of the property owner.
APPLICANT PHONE NUMBER: Phone number where applicant can be reached.
APPLICANT EMAIL ADDRESS:Email address where applicant can be reached.
APPLICANT MAILING ADDRESS:Address where applicant can be reached.
PROPERTY ADDRESS:Address of the property where the BMPs will be installed or instituted.
PROPERTY UTILITY ACCOUNT NUMBER: The utility billing number associated with the property. This
number can be found on the property's utility bill or by calling Carmel Utilities at 317-S71-2442.
PROPERTY PARCEL NUMBER: The parcel identification number associated with the property. This
number can be found on property tax records or from the Hamilton County Recorder's Office at 317-
776-9618 or online at http://eis.hamiltoncounty.in.gov/FlexViewer/Index.html
COST-SHARE APPLYING FOR: Indicate the one or more cost-shares)for consideration. See Chapter 3 of
this Credit Manual for an explanation of each cost-share
APPLICANT SIGNATURE: Signature of applicant.
DATE: Date application is submitted.
APPENDIX 4
LIST OF EDUCATIONAL RESOURCES
EXAMPLES OF EXISTING EDUCATIONAL RESOURCES
IDEM Classroom Resources(http://www.in.gov/idem/nps/3459.htm)
IDNR Project WET(http://www.in.gov/dnr/fishwild(7546.htm)
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EPA NPDES Storm Water Outreach Materials and Reference Documents
(http://cfpub.epa.gov/npdes/stormwatermonth.cfm#materials)
EPA Teacher Resources and Lesson Plans(http://www.epa.gov/students/teachers.html)
EPA Water science and Technology for Students and Educators(http://water.epa.gov/learn/resources/)
USGS Education Resources(http://education.usgs.gov/)
APPENDIX 6
Target Areas Map
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Legend
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Cool Creek Watershed
Industrial Zoning
QCarmel
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