HomeMy WebLinkAbout326998 06/29/18 J'%� "''F. CITY OF CARMEL, INDIANA VENDOR: 366545
ONE CIVIC SQUARE OLD TOWN DESIGN GROUP CHECK AMOUNT: $*****2,457.00*
ate; CARMEL, INDIANA 46032 1132 RANGELINE ROAD CHECK NUMBER: 326998
.y«oN�, CARMEL IN 46032 CHECK DATE: 06/29/18
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1192 5023990 NONE 2,457.00 OTHER EXPENSES
VOUCHER NO. WARRANT NO.
ALLOWED 20
IN SUM OF $
(0 03
ON ACCOUNT OF APPROPRIATION FOR
Docs
Board Members
Po#or INVOICE NO. ACCT#!TITLE AMOUNT
DEPT.# /' I hereby certify that the attached invoice(s), or
-))q57,06 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
Signature
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund
"COMPLETE& RETURN
REFUND REQUEST THIS FORiM TO:
Building&Code Services City of Carmel
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M .... 1.
W.e Ph. (317) 571-2444 Fax (317) 771-2499 Building&Code Services
One Civic Square;
Carmel, IN 46032
PERMIT #(s): 17110064
Lot & Subdivision, or Address of Construction:
100 Sunrise-Spec Oliver 1512 Evenstar Boulevard, Indianapolis IN 46280
(If more than one address needs to be listed and will not fit, please attach a printed list of all permits,with
their corresponding permit#.) I
Please print or type the reason for the requested refund, and specific fee or fees
which are requested, in the lines below:
We were, inadvertently, charged the PRIF fees in the amount of$2,457.00.We should not have been
charged this, as we have prepaid these, as the developer.
TO .Al- REFUND AMOUNT RAE "E-STED: _$2457.00
6/18/2018
AWlici`ntSignature "-I- -Vf Date
Krist! Huffman Old Town Design Group
Applicant Name-Printed Company Name(If applicable)
APPLICANT ADDRESS:
1132 S. Rangeline Road, Suite 200
Street Address
Carmel IN 46032
City ST Zip
806-231-6736
Phone# Fax
FOR OFFICE USE ONLY:
p Total amount for fees that ARE available for refund: 9-7
p Fees that are NOT available for refund:
p Refund approved by: Date:
p Date submitted for Paya Amount Approved:
do
CITY OF CARMEL
10 ITEMS OF 10 PERMIT RECEIPT OPERATOR: plux
COPY # 1
Sec:12 Twp:17 Rng:3 Sub:SOTM Blk: Lot:100
PARCEL ID . . . . . . . . : 1713120001100000
DATE ISSUED. . . . . . . : 11/29/2017
RECEIPT #. . . . . . . . . : BC000014782
REFERENCE ID # . . . 17110064
SITE ADDRESS . . . . . : 1512 EVENSTAR BLVD
SUBDIVISION . . . . . . : SUNRISE ON THE MONON
CITY . . . . . . . . . . . . . . INDIANAPOLIS
IMPACT AREA . . . . . .
OWNER . . . . . . . . . . . . : OLD TOWN DEVELOPMENT, LLC
ADDRESS . . . . . . . . . . : 1132 SOUTH RANGE LINE ROAD
CITY/STATE/ZIP . . . : CARMEL, IN 46032
RECEIVED FROM . . . . : OLD TOWN DESIGN GRO
CONTRACTOR . . . . . . . : *OLD TOWN DESIGN LIC # OLDTOWN
COMPANY . . . . . . . . . . : *OLD TOWN DESIGN
ADDRESS . . . . . . . . . . : 1132 S RANGELINE RD STE 200
CITY/STATE/ZIP . . . : CARMEL, IN 46032
TELEPHONE . . . . . . . . : (317) 626-8486
FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
---------- ------------- ---------- ---------- ---------- ---------- ----------
IRESELEMTR PER INSPECTIO 1. 00 70 .00 0. 00 70 .00 0 . 00
IRESFINAL PER INSPECTIO 1. 00 70 . 00 0. 00 70 .00 0 . 00
IRESFTSLB PER INSPECTIO 1. 00 70 . 00 0. 00 70 .00 0 .00
IRESFTSLB+ PER INSPECTIO 1. 00 70 . 00 0. 00 70 .00 0 . 00
IRESROUGH PER INSPECTIO 1. 00 70 . 00 0 . 00 70 .00 0 . 00
PRIF ## DWELL.UNITS 1. 00 2457 .00 0. 00 2457 .00 0 . 00
RESC/0 FLAT RATE 1. 00 67 . 00 0. 00 67.00 0 . 00
RESSINGLE SQUARE FEET 2, 768 . 00 799 .48 0. 00 799.48 0 . 00
USFWATCONN FLAT RATE 1. 00 2961. 00 0. 00 2961.00 0 . 00
UWATERTAP FLAT RATE 1. 00 117 . 00 0. 00 117.00 0 . 00
---------- ---------- ---------- ----------
TOTAL PERMIT 6751.48 0. 00 6751.48 0 . 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- --------------------
CHECK 6, 751.48 81920
---------------
TOTAL RECEIPT 6, 751.48