HomeMy WebLinkAbout327799 07/20/18 `�V.��`''• CITY OF CARMEL, INDIANA VENDOR: 372575
ONE CIVIC SQUARE JENNIFER J. MYERS CHECK AMOUNT: $********50.00*
9 '�� CARMEL, INDIANA 46032 12 GREEN COURT CHECK NUMBER: 327799
.y�TON�` CARMEL IN 46033 CHECK DATE: 07/20/18
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
250 4350900 50.00 OTHER CONT SERVICES
VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201(Rev.1995)
Vendor# 372575 ALLOWED 20 ACCOUNTS PAYABLE VOUCHER
JENNIFER J. MYERS IN SUM OF$ CITY OF CARMEL
12 GREEN COURT 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 46033
Payee
$50.00
ON ACCOUNT OF APPROPRIATION FOR Purchase Order#
Engineering
Terms
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 7/9/18 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
Wednesday,July 18,2018
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—
Cost
20Cost distribution ledger classification if claim paid motor vehicle highway fund. Clerk-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/Denied Date
Myers Jennifer 12 Green Court Carmel 46033 iohnsonj1521@yahoo.com 937-360-9156 5/3/2018 1 Rain Barrel No -- 1$50 — -- Approved _17/9/2018_f
Submitted for Payment on 7-9-18 — i
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RESIDENTIAL COST-SHARE APPLICATION
of Cap
CITY OF CARMEL STORM WATER USER FEE
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APPLICATION TYPE: Initial Application _Installation Verification
APPLICANT NAME: APPLICANT PHONE NUMBER:
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APPLICANT EMAIL ADDRESS: APPLICANT MAILING ADDRESS:
D1�1n5�°r1.
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PROPERTY ADDRESS: '2 ��('t' �� b"�_- I �C�.�( `�I'�� I ��t LI U D3
PROPERTY UTILITY ACCOUNT NUMBER: PROPERTY PARCEL NUMBER:
0330r� _Nqo-��
Via- I LA US �A-Gtq, vii
COST-SHARE APPLYING FOR:
_,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 ater utility credit. Denial of this right will result in
the loss of the storm water credit. Applicant's Initials
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@carmeLin.gov
Required attachments for the Residential Cost-share Incentive
INITIAL APPLICATION ATTACHMENTS INSTALLATION VERIFICATION ATTACHMENTS
Sketch of Site and Location of BMP(s) �Z os of Installation
_Photos of Site Receipts
Application Fee
For Department of Storm water Management Use
APPLICANT NAME: PROPERTY ADDRESS:
DATE RECEIVED: RECEIVED BY:
J oM
TARGET AREA: IQPPROVED
COOL CREEK WATERSHED 9—COST-SHARE AMOUNT
REIMBURSEMENT SENT
DENIED(Reason)
STAFF SIGNATURE—) DATE:
22
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Receipt
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niame:
--- _.._ Amount:
Paid: Check ik -
- Rain Barrel#:
Signature:
iL Date:
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