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HomeMy WebLinkAbout331858 10/31/18 CITY OF CARMEL, INDIANA VENDOR: 372899 • ONE CIVIC SQUARE MUDSLINGERS POOL CHECK AMOUNT: $*******284.20* CARMEL, INDIANA 46032 5575 ELMWOOD AVE#D CHECK NUMBER: 331858 INDIANAPOLIS IN 46203 CHECK DATE: 10/31/18 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1192 5023990 284.20 OTHER EXPENSES VOUCHER NO. WARRANT NO. .- 89aN9 ALLOWED 20 A' IN SUM OF $ o ON ACCOUNT OF APPROPRIATION FOR Board Members Po#or INVOICE NO. ACCT#/TITLE AMOUNT DEPT.# I hereby certify that the attached invoice(s), or tl nv 50 A39,q b fa84.AD bill(s) is (are) true and correct and that the 1 O 1 materials or services itemized thereon for which charge is made were ordered and received except r-J 9--fw Signature Title Cost distribution ledger classification if claim paid motor vehicle highway fund i QF CA REFUND REQUEST - Building& Code SeMces Ph. (317)571-2444 Pax(317)571-2499 t 10 1 Ali PERMIT#(s): ©� 3 Lot&Subdivision or Address of Construction: r Permit e: Reason for refund request: ' i OY1 i . i I TOTAL REFUND AMOUNT REQUESTED: aS�- �a f I APPLICANT: ' Applicant Name—Printed G pany Name(if applicable) ,5(5IS ElAdR & sig D Street Address �i�n,r-D1119, - , City ST ZIp e�IVSD-sic?I Phone# Fax# Residential requests must occur within 180 days from the issuance date of the permit. Commercial/InsdtutionaVMulti Panvly requests must occur within i 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 Inspection Fees Certificate of Occupancy or Substantial Completion Fees Park and Recreation Impact Fees Carmel Utility Water/Sewer Fees Square Footage Fees: 1415, Pio Inspection Fees: Q C? PRIF: Certificate of Occupancy: �v Water Sewer Fees: TOTAL REFUND: witoLo Original receipt date: 1 b-q--! Receipt Number., ncjOCj I la Co 10 Date: Refund approved by: a- CITY OF CARMEL 4 ITEMS OF 4 PERMIT RECEIPT OPERATOR: plux COPY # 1 Sec: Twp:18 Rng:03 Sub:004 B1k:27 Lot:90 PARCEL ID . . . . . . . . : 1709270004015000 DATE ISSUED. . . . . . . : 10/09/2018 RECEIPT #. . . . . . . . . : BC000016619 REFERENCE ID # . . . : 18080133 SITE ADDRESS . . . . . : 12958 BRIGHTON AVE SUBDIVISION . . . . . . : SPRINGMILL STREAMS CITY . . . . . . . . . . . . . . CARMEL IMPACT AREA . . . . . . OWNER . . . . . . . . . . . . : BERTOLINI, CLAUDIO & ANNA ADDRESS . . . . . . . . . . : 12958 BRIGHTON AVE CITY/STATE/ZIP . . . : CARMEL, IN 46032 RECEIVED FROM . . . . : *MUD SLINGER POOL CONTRACTOR . . . . . . . : *MUD SLINGER POOL LIC # MUDSLIN COMPANY . . . . . . . . . . : *MUD SLINGER POOL ADDRESS . . . . . . . . . . : 5575 ELMWOOD AVE. , #D CITY/STATE/ZIP . . . : INDIANAPOLIS, IN 46203 TELEPHONE . . . . . . . . : (317) 650-5131 FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL ---------- ------------- ---------- ---------- ----------- ---------- ---------- IRESBNDGND PER INSPECTIO 2 . 00 142 .00 0 . 00 142 .00 0 . 00 IRESFINAL 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 RESPOOL SQUARE FEET 1,320 . 00 498 .20 0. 00 498 .20 0 . 00 ---------- ---------- ---------- ---------- TOTAL PERMIT 779 .20 0. 00 779 .20 0. 00 METHOD OF PAYMENT AMOUNT REFERENCE NUMBER ----------------- --------------- -------------------- CHECK 779.20 10196 --------------- TOTAL RECEIPT 779.20