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Home My WebLink About198561 06/22/2011 CITY OF CARMEL, INDIANA VENDOR: 365414 Page 1 of 1 ONE CIVIC SQUARE HOMES BY DESIGN CARMEL, INDIANA 46032 4239 W 96TH ST CHECK AMOUNT: $4,175.01 INDIANAPOLIS IN 46033 CHECK NUMBER: 198561 CHECK DATE: 6122/2011 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 101 5023990 4,175.01 OTHER EXPENSES May 08 03 10;08p Jamie Brashear 3175690004 p.2 I To. Hollibaugh, Mike P Cc: Jamie Brashear Subject: Residential Building Permit 11030138 HI Mike, My wife and I have decided to not build a home on our lot at 3533 Sedgemoor Circle, Permit #11030138 issued 41612011 to our then anticipated builder, Homes by Design. As we will not be building we wanted to remove the permit and seek any possible refunds. Our mailing address is Ryan Jamie Brashear, 12153 Bayhill Dr, Carmel, IN 46033, Thanks in advance, Ryan Brashear Home 569 -0004 Cell 694 -5265 61612011 CITY OF CARMEL 8 ITEMS OF 8 PERMIT RECEIPT OPERATOR: edruley COPY 1 Sec: Twp::_17 Rng:03 Sub:021 Blk:05 LgL:52 PARCEL I`D 1713050005009000 DATE ISSUED.......: 04/06/2Cll RECEIPT BC000001327 REFERENCE ID 11030138 SITE ADDRESS 3533 SEDGEMOOR CIR SUBDIVISION BRIDLEBOURNE- CITY CARMEL IMPACT AREA OWNER BRASHEAR, DR. RYAN JAMIE ADDRESS ...........12153 BAYi•IILL DR. CITY /STATE /ZIP CARMEL, IN 46033 RECEIVED FROM HOMES BY DESIGN CONTRACTOR HOMES BY DESIGN ID- I=CMEDES COMPANY HOMES BY DESIGN ADDRESS 4239 W 96TH ST CITY /STATE /ZIP INDIANAPOLIS, IN 462'68 TELEPHONE (317) 228 -0058 FEE ID UNIT QUANTITY AMOUNT PD -TO -DT THIS REC NEW BAL IRESELEMTR-PER INSPECTIO 1.00 61.50 0.00 61.50 0.00 C ZRESFINAL PER INSPECTIO 1.00 61.50 0.00 61.50 0.00 IRESFTSLB PER INSPECTIC- 2.00 123.00 0.00 123.00 0.00 IRF,SFTSLB+ PER INSPECTIO 1.00 61.50 0.00 61.50 0.00 IRESROUGH PER INSPECTIO 1.00 61.50 0.00 61.50 0.00 PRIF DWELL.UNI,TS 1.00 1261.00 0.00 1261.00 0.00 RESC /O FLAT RATE 1.00 59.50 0.00 59.50 0.00 RESSINGLE SQUARE FEET 18,691.00 2485.51 0.00 .2485.51 0.00 TOTAL PERMIT 4175.01 0.00 41.75.01 0.00 METHOD OF-PAYMENT AMOUNT REFERENCE NUMBER CHECK 4,175.01 11603 TOTAL..RECHiIPT 4,175.01 May 08 03 10:08p Jamie Brashear 3175690004 p.1 *'"COMPLETE &I RETURN REFUND REQUEST THIS FORM TO: Building Code Services City of Carmel 5 6 9 PL (317) 571 -2444 Fax (317) 571 -2499 Building Code SEtvices �D r. One Civic Square; Carmel, ICI 46032 PERMIT ilo Lot Subdivision, or Address of Construction: �n �S �o- 5a. g�Lao�rr L3ou�rJ� 3533 (If more than one address needs to be fisted 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: TOTAL REFUND A IOUNT REQUESTED: 75 O j Applicant SKnature Date Applicant Name— Printed Company blame (If applicable) APPLICANT ADDRESS: i a 1 5 3 B A leRr Arc Street Address AP- M _L ti 3 1 51 1 5tp Li Phone Fax FOR OFFICE USE ONLY p Total amount for fees 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: May 08 03 10:08p Jamie Brashear 3175690004 p.3 REFUND REQUESTS MUST OCCUR WrTHIN: RESIDENTIAL PERMITS Within 180 days from the issuance date cf the permit. COMMERCIAL/INSTITUTIONAL/MULTI-FAMILY: Within 1 year of the issue date of the State Commercial Design Release (CDR) there is NO CDR they need to begin within 1 year of the issuance date of the permit, FEES WHICH MAY BE REFUNDED ARE: Inspection Fees. Count the number of inspections charged on an ILP application (assessed by plan review). Certificate of Qrnirgncy or Substantial Completion Fees. To be refunded. PRIF Fee. To be refunded. Fees (re- inspection, late fees, "other" inspection fees); Refunds can be made if it has been determined that a "clearly defined error" has been made when a re- inspection, late, and/or "other'r fee has been assessed. NOTE: If an ILP has gone beyond 180 days for start of construction, no refund can be geRerated because the ILP is technical! y frvalid ex fired. If however the applicant has requested, and has been granted an extension of time rior to the 184 da deadline a refund could still be granted, all under the terms as outlined above. NOTE: Applicants requesting refunds for sewer and/or water permits should be directed to the utility provider. (Carmel Utilities or CTRWD.) 5, Permits /Forms /Refund Request Form Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No. 201 (Rev. 1995) CITY OF CARMEL 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. Payee aD Purchase Order No. 7,4 �q Gy 9(p �l Terms 4 ✓►OQ" p-n !!hqb l 1 ,I L" Date Due Invoice Invoice Description Amount Date Number (or note attached invoice(s) or bill(s)) All MI/ Total d 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 Clerk- Treasurer VOUCHER NO. WARRANT NO. ALLOWED 20 t(Dm�sy IN SUM OF 7rds0?r VJ li3, 44 3 ON ACCOUNT OF APPROPRIATION FOR Board Members PO# or INVOICE NO. ACCT #!TITLE AMOUNT DEPT. 1 hereby certify that the attached invoice(s), or 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 20j na Cost distribution ledger classification if Title claim paid motor vehicle highway fund