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Home My WebLink About327249 07/10/18 CITY OF CARMEL, INDIANA VENDOR: 372561 \. ONE CIVIC SQUARE TIMOTHY D.SCHIRACK CHECK AMOUNT: $********50.00* CARMEL, INDIANA 46032 2534 MURPHY CIRCLE N. CHECK NUMBER: 327249 yTON�° CARMEL IN 46074 CHECK DATE: 07/10/18 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 250 4350900 50.00 OTHER CONT SERVICES VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev.1995) Vendor# 372561 ALLOWED 20 ACCOUNTS PAYABLE VOUCHER TIMOTHY D. SCHIRACK IN SUM OF$ CITY OF CARMEL 2534 MURPHY CIRCLE N. An invoice or bill to be properly itemized must show:kind of service,where performed,dates service rendered,by whom,rates per day,number of hours,rate per hour,number of units,price per unit,etc. CARMEL, IN 46074 Payee $50.00 Purchase Order# ON ACCOUNT OF APPROPRIATION FOR Terms EnQineerinq Date Due PO# ACCT# DATE INVOICE# DESCRIPTION DEPT# INVOICE# Fund# AMOUNT Board Members DEPT# FUND# (or note attached invoice(s)or bill(s)) AMOUNT 0 43-509.00 $50.00 1 hereby certify that the attached invoice(s),or 7/2/18 0 Rain Barrel Residential Cost Share $50.00 2200 250 2200 250 Reimbursement bill(s)is(are)true and correct and that the materials or services itemized thereon for which charge is made were ordered and received except Thursday,July 05,2018 Jeremy Kashman Director I hereby certify that the attached invoice(s),or bill(s),is(are)true and correct and I have audited same in accordance with IC 5-11-10-1.6 ,20— Clerk-Treasurer 20Clerk-Treasurer Rain Barrel Residential Cost Share �......-.__..___ __.-...... Last name First name Street address City Zip E-mail address Contact Phone App Date Cost-Share Target Area;Reimbursement Amt 'Approved 1 Denied 'Date �'Schirack Timothy 2534 Murphy Circle North (Carmel 46074 tdschiracksr@gmaii.com 765-418-0940 6/5/2018 �1 Rain Barrel ;No 1$50 Approved 7/2/2018 — Submitted for Payment on 7-2-18 --- }-_ -_------- - __-i-- - - -- --- -- _ 1 I i 1 --- - --- — -- ��---- _ — -- - - - RESIDENTIAL COST-SHARE APPLICATION ' of C� � Fa-rrh V �W� CITY OF CARMEL STORM WATER USER FEE RESIDENTIAL COST-SHARE APPLICATION to arrn�� APPLICATION TYPE: V11 Initial Application ►�Installation Verification APPLICANT NAME: APPLICANT PHONE NUMBER: 76 796L APPLICANT EMAIL ADDRESS: APPLICANT MAILING ADDRESS: aS341 Mvri ky r Crtrme�, i�l e1607y PROPERTY ADDRESS: 6a C m I Z/6, 0 7 PROPERTY UTILITY ACCOUNT NUMBER: PROPERTY PARCEL NUMBER: Crr c-me.f USI sI i 11y,�c13796 69 -,O—ao- '-6,3q ,6bb COST-SHARE APPLYING FOR: x 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 Initia[9-76 n APPLICANT SIGNATURE: DATE: 21 Submit application and attachments to: City of Carmel Engineering Department Attn: Department of Storm water Management One Civic Square Carmel, IN 46032 stormwater@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: -�J-o��^' TARGET AREA: LAAPPROVED COOL CREEK WATERSHED COST-SHARE AMOUNT REIMBURSEMENT SENT DENIED(Reason) STAFF SIGNATURE: DATE: 22 mail Timothy Schirack <tdschiracksr@gmail.com> Thank you for your order! Hamilton County Soil and Water Conservation District <no- Fri, Apr 20, 2018 at 6:52 reply@editmysite.com> AM Reply-To: soil.water@hamiltoncounty.in.gov To: TDSCHIRACKSR@gmail.com Order No. 1086905955 Thank you for your purchase! 80.25 VISA ...8726 — Visa Billing Information Shipping Information VISA ...8726 — Visa Timothy Schirack 2534 Murphy Cir N Timothy Schirack CARMEL, IN 46074 2534 Murphy Cir N us CARMEL, IN 46074 TDSCHIRACKSR@GMAIL.COM us 765-418-0940 TDSCHIRACKSR@GMAIL.COM 765-418-0940 Order Summary ITEM DESC QUANTITY TOTAL $75 Rain Barrel (55 gallon)- pick up 1 $75.00 only Color: Grey Subtotal $75.00 Shipping $0.00 Tax $5.25 TOTAL $80.25 This email was sent to you by Hamilton County Soil and Water Conservation District 1717 Pleasant St. Suite 100 Noblesville, IN 46060 317-773-2191 1 www hanii(tonswcd.org .. .tl.. 11. - .�'� '.r •�, _ .1 sit.+klY ' a 1 i D,�C 'Wt44'""J For I C1� ,k�, �fi�al� alV�t�. ��IftJ.�4 I i��i �•{�n,rl g� I r'dV I 'Y Or 1��4 ��b{>� ti•Ih �s r ,t t I � ^F.�rvl�Ip, ILiI��"�J��YI�k"�i��I"�y aI � � i�� i �ft�"9 ,,;v �q,` 9�I J 1 � 1HY" o s ... .. i• � f k r f.µii j''�t J��+r�r I f I I I� r,M I� NI�i+�+I$�. �`7�i°J' I t1 , I Y' �� ,, r,_. 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