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HomeMy WebLinkAbout332489 11/21/18 +�r_CggM CITY OF CARMEL, INDIANA VENDOR: 372934 4/ ONE CIVIC SQUARE NANCY BENNETT CHECK AMOUNT: $********50.00* CARMEL, INDIANA 46032 2106 PINEHURST DR CHECK NUMBER: 332489 �Mti6d�co CARMEL IN 46032 CHECK DATE: 11/21/18 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 250 4350900 50.00 OTHER CONT SERVICES VOUCHER NO. WARRANT NO. Prescribed by State Board of Accounts City Form No.201 (Rev.1995) Vendor# 372934 ALLOWED 20 ACCOUNTS PAYABLE VOUCHER NANCY BENNETT IN SUM OF$ CITY OF CARMEL 2106 P I N EH U RST DR 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 46032 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 11/16/18 0 Residential Cost Share-Rain Barrel $50.00 2200 250 2200 250 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 Friday, November 16,2018 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 distribution ledger classification if claim paid motor vehicle highway fund. Clerk-Treasurer RESIDENTIAL COST-SHARE APPLICATION ®t caP *4 O �TON, CITY OF CARMEL STORM WATER USER FEE RESIDENTIAL COST-SHARE APPLICATION e Vb a APPLICATION TYPE: Vinitial Application —Installation Verification APPLICANT NAME: APPLICANT PHONE NUMBER: tq a r)c-q 13er)ne 3I -7 �qS qt®' APPLICANT EMAIL ADDRESS: APPLICANT MAILING ADDRESS: n be�n�� �c comcas`1. rte a f b l� Pi ne h u rsf Dr. PROPERTY ADDRESS: ( d P I n-e / ) ,A Ys� SCJ r. PROPERTY UTILITY ACCOUNT NUMBER: PROPERTY PARCEL NUMBER: 1& 92-&) 38DO a3 -p3 - 00-7, 000 COST-SHARE APPLYING FOR: V 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 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) _Photos of Installation V Photos of Site Receipts �aApplication Fee For Department of Storm water Management Use APPLICANT NAME: PROPERTY ADDRESS: DATE RECEIVED: RECEIVED BY: TARGET AREA: &PROVED _COOL CREEK WATERSHED ,COST-SHARE AMOUNT —REIMBURSEMENT SENT _DENIED(Reason) STAFF SIG DATE: S Bll 22 ►. h , r� � - — . _ - .. . ; - �___-.��._-' -..r__._ "_ �_' -�� -� tea_ - �r �� -�:�- - ._- ,� - . ,�,. - �� , � � -� t