HomeMy WebLinkAbout327720 07/20/18 �or_c�,yM
�y \,. CITY OF CARMEL, INDIANA VENDOR: 366545
ONE CIVIC SQUARE OLD TOWN DESIGN GROUP CHECK AMOUNT: $*****1,073.98*
,�; CARMEL, INDIANA 46032 1132 RANGELINE ROAD CHECK NUMBER: 327720
9M,�TON�. CARMEL IN 46032 CHECK DATE: 07/20/18
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1192 5023990 REFUND 1,073.98 OTHER EXPENSES
VOUCHER NO. WARRANT NO.
r
�n J ALLOWED 20
IN SUM OF $
13
$A, o7-3 .a �
ON ACCOUNT OF APPROPRIATION FOR
.�CS
Board Members
PO#or INVOICE NO. ACCT#/TITLE AMOUNT
DEPT.# Ihereby certify that the attached invoice(s), or
4 l 0`73.9%dill(s) is (are) true and correct and that the
101 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
+7rr� "COMPLETE& RETURN
REFUND REQUEST THIS FORM TO:
Budding &Code Services City of Carmel
o Building&t Code Services
F1 : ,; Ph. (317) 571-2444. Fax (317) 571-2499
' One Civic Square;
--- Carmel, Iv 46032
PERMIT #(s): 18050116
Lot & Subdivision, or Address of Construction:
131 Sunrise-1459 Sundown Circle, 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#.)
Please print or type the reason for the requested refund, and specific fee or fees
which are requested, in the lines below:
Customer decided not to build with us.
TOTAL REFUND AMOUNT REQUESTED: I�1b' " CAOW
AL�Wa Z-Al cul I
App scant Signature. Date
Kristi Huffman Old Town Design Group
Applicant Name—Printed Company Name(If applicable)
APPLICANT ADDRESS:
1132S. Rangeline Road Suite 200
Street.Address
Carmel Indiana 46032
City ST Zip
I
806-231-6736
Phone# Fax#
FOR OFFICE USE ONLY:
p Total amount forfees that ARE available for refund:
p Fees that are NOT available for refund:
p Refund approved by: Date:
p Date submitted for Payment: Amount Approved:
I
i
Residential requests must occur within 180 days from the issuance date of the permit.
Commercial/Institutional/Multi-Family requests must occur within 1 year of the issue date of the State
Design Release. If no State Design Release was required,the refund must be requested within 1 year-from
issuance date of the permit.
The following fees are eligible for refund:
Square Footage Fees A-zQ-
Inspection Fees
Certificate of Occupancy or Substantial Completion Fees
Park and Recreation Impact Fees
Carmel Utility-Water/Sewer Fees
Square Footage Fees: (0 5d.
Inspection Fees: 3 55.00
PRIF:
Certificate of Occupancy:
Water Sewer Fees:
TOTAL REFUND: IO73.
Original receipt date: Receipt Number: E)G OOOC) 7 14115-
Date: -7
Refund approved by-- &fMCjTjAd,'
a
J
CITY OF CARMEL
7 ITEMS OF 7 PERMIT RECEIPT OPERATOR: plux
COPY # 1
Sec:12 Twp:17 Rng:3 Sub:SOTM Blk: Lot:131
PARCEL ID . . . . . . . . : 1713120001131000
DATE ISSUED. . . . . . . : 05/23/2018
RECEIPT #. . . . . . . . . : BC000015745
REFERENCE ID # . . . : 18050116
SITE ADDRESS . . . . . : 1467 SUNDOWN CIR
SUBDIVISION . . . . . . : SUNRISE ON THE MONON
CITY . . . . . . . . . . . . . : INDIANAPOLIS
IMPACT AREA . . . . . .
OWNER . . . . . . . . . . . . : MORAN, CATHERINE C
ADDRESS . . . . . . . . . . : 1509 EVENSTAR, APT #130
CITY/STATE/ZIP . . . : INDIANAPOLIS, IN 46280
RECEIVED FROM . . . . : *OLD TOWN DESIGN
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 71.00 0 . 00 71. 00 0 . 00
IRESFINAL PER INSPECTIO 1. 00 71.00 0 . 00 71 . 00 0 . 00
IRESFTSLB PER INSPECTIO 1. 00 71.00 0 . 00 71. 00 0 . 00
IRESFTSLB+ PER INSPECTIO 1. 00 71.00 0 . 00 71. 00 0 . 00
IRESROUGH PER INSPECTIO 1. 00 71.00 0 . 00 71. 00 0 . 00
RESC/0 FLAT RATE 1. 00 68 .00 0 . 00 68 . 00 0 . 00
RESSINGLE SQUARE FEET 5, 918 . 00 1157.98 0 . 00 1157 .98 0 . 00
---------- ---------- ---------- ----------
TOTAL PERMIT 1580 .98 0 . 00 1580 . 98 0 . 00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
----------------- --------------- --------------------
CHECK 1,580 .98 83648
---------------
TOTAL RECEIPT 1,580 .98