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