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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 (46V ml-�Dkm= 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