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Home My WebLink About178114 10/14/2009 (9) CITY OF CARMEL, INDIANA VENDOR: 074600 Page 1 of 1 ONE CIVIC SQUARE DEPT.OF NATURAL RESOURCES CHECK AMOUNT: $10.00 CARMEL, INDIANA 46032 DIV OF FISHlWILDLIFE -COMM LIC. CLR 402 W. WASHINGTON ST., ROOM W273 CHECK NUMBER: 178114 INDIANAPOLIS IN 46204 CHECK DATE: 10/1412009 DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION 1125 4350400 PERMITS 10.00 GROUNDS.MAINTENANCE Carmel a Clair Parks &Recreation CHECK REQUEST Date: 9128109 c r-� r Check payable to s E N Name: Department of Natural Resources e-' 2009 Division of Fish and Wildlife Commercial License Clerk Address: 402 West Washington St Room W273 City, State, Zip Indianapoils, IN 46204 x Mail check to payee Return check to requestor Check Amount 10.00 Date Reguired T _658P Check needed for vegetation control permits Supporting documentation or receipt(s) MUST be attached. To be paid from Po N A Budget account GL 1125- 430 100 4350400 ($5.00) 1125 -430- 105 4350400 ($5.00) Budget Line Description grounds maintenance Requested by (print): Serra Garske Requested by (signature). Approved by (signature of Division Manager on this date 6 Form revised 1 -21 -08 Return to: Page 1 of APPLICATION FOR AQUATIC FOR OFFICE USE ONLY DEPARTMENT OF NATURAL RESOURCES VEGETATION CONTROL PERMIT License No. Division of Fish and Wildlife State Form 26727 (R4/ 2 -04) Commercial License Clerk Approved State Board of Accounts 2004 Date Issued 402 West Washington Street, Room W273 Whole Lake Multiple Treatment Areas Indianapolis, IN 46204 Check type of permit Lake County INSTRUCTIONS: Please print or type information FEE: $5.00 Applicant's Name Lake Assoc. Name Rural Route or Street Phone Number City and State ZIP Coq V. Certified Applicator (if applicable) Company or Inc. Name Certification Number Rural Route or Street Phone Number City and State ZIP Code Lake (One application per lake) Nearest Town County Does water flow into a water supply Yes No Please complete one section for EACH treatment area. Attach lake map showing treatment area and denote location of any water supply Intake. Treatment Area fl 7T/LONG or UTM's E- Total acres to be controlled 5 Proposed shoreline treatment length (ft) 1� 05 1 Perpendicular distance from shoreline (it) Q` Maximum Depth of Treatment it (,p Expected dale(s) of treatment(s) S O r at7 Treatment method: ®Chemical Ophysical Biological Control Mechanical Based on treatment method, describe chemical used, method of physical or mechanical control and disposal area, or the species and stocking rate for biological control. 1 LD 0'L i rk- W (On Qr Plant survey method: Rake Visual Other (specify) Aquatic Plant Name Check if Target Relative Abundance Species of Community JIL Page --g9 of 3 Treatment Area LAT /LONG or UTM's Total acres to be controlled Pro sed shoreline treatment length (ft) Perpendicular distance from shoreline (ft) Maximum Depth of Treatment it Expected date(s) of treatment(s) Treatment method: Chemical Physical Biological Control Mechanical Based on treatment method, describe chemical used, method of physical or mechanical control and disposal area, or the species and stocking rate for biological control. Plant survey method: E]Rake E]Visuai Other (specify) Aquatic Plant Name Check if Target Relative Abundance Species of Community INSTRUCTIONS: Applicant must sign the application and is the only signature required. If applicant is also a certified chemical applicator, sign the "certified applicator" signature box Applicant n ure Date q Certified Applicator's Signature Date FOR OFFICE ONLY Fisheries Staff Specialist Approved Disapproved Environmental Staff Specialist D Approved 1:1 Disapproved Mail check or money order in the amount of $5.00 to: DEPARTMENT OF NATURAL RESOURCES DIVISION OF FISH AND WILDLIFE COMMERCIAL LICENSE CLERK 402 WEST WASHINGTON STREET ROOM W273 INDIANAPOLIS, IN 46204 3�3 I I I I 1 J I1 r�\ t v odd Area J Open Flclde a JI J Tra I I y C7 p l —Grant ��7 o and 4Ianting dog t I 1 AA� trail r roll Grant m Park bury SF+slter �!I Parking of l 'Ra n C1 040 wato feature 1 8winge I O' o I Pon ltL�et 401 I mitt X 11 n s w!B Ides I (5prl 2 2) I Q atru I Q �J I ctor ey Q ralrle l aze 4 Girden a N W est Park $ite Pia 0 100' 200' 400' Cnnstmotian- Om late tO Fall 2001 Scal a I' 2 November 21, 2 001 Return to: Page 1 of APPLICATION FOR AQUATIC FOR OFFICE USE ONLY DEPARTMENT OF NATURAL RESOURCES VEGETATION CONTROL PERMIT License No. Division of Fish and Wildlife State Form 26727 (134 12-04) Commercial License Clerk A roved State Board of Accounts 2004 Date Issued 402 West Washington Street, Room W273 Whole take Multiple Treatment Areas Indianapolis, IN 46204 Check type of permit Lake County INSTRUCTIONS: Please print or type information FEE: Applicant's Name Lake Assoc. Name �>cktA�rs NG LA E-1_ L LAY P R K 4 Ra Rural Route or Street Phone Number 14 ii1 E. 1 STRE E-T S 1. i -AA City and State ZIP Code R IN 4 -Cna3Z Certified Applicator (It applicable) Company or Inc. Name Certification Number Rural Route or Street Phone Number City and State ZIP Code Lake (One application per lake) Nearest Town County TPPSI.- U �n-Ac� L r 1__ 4 A M 1 Does water flow into a water supply Yes No LeN Please complete one section for EACH treatment area. Attach lake map showing treatment area and denote location of any water supply intake. Treatment Area LA 1LLONG or UTM's Total acres to be controlled �J Proposed shoreline treatment length (ft) tP0 Pe endicular distance from shoreline (ft) Maximum Depth of r Treatment ft f;,p Expected date(s) of treatment(s) Treatment method: ®Chemical ®Physical Biological Control Mechanical Based on treatment method, describe chemical used, method of physical or mechanical control and disposal area, or the species and. stocking rate for biological control. R 0 UQ r o CAi"lU .O t 1711 e- Plant survey method: Rake I Ul Visual Other (specify) Aquatic Plant Name Check if Target Relative Abundance Species of Community J q Page of 7 Treatment Area or UTM's �R�F ER rb 1 N P Total acres to be controlled Proposed shoreline treatment length (ft) D�$ Perpendicular distance from shoreline (ft) 15. 6 bui 4A) Maximum Depth of Treatment (ft) J Expected date of treatment(s) C) D Treatment method: ®Chemical ®Physical Biological Control Mechanical Based on treatment method, describe chemical used, method of physical or mechanical control and disposal area, or the species l and stocking (r� rate for biological control. OZ a 00 Q d Z e, KJcv- co 4 0 11 ons r Plant survey method: Rake visual Other (specify) Aquatic Plant Name Check if Target Relative Abundance Species of Community 1, 5 /p INSTRUCTIONS: Applicant must sign the application and is the only signature required. If applicant is also a certified chemical applicator, sign the "certified applicator" signature box Applicant Si, toe Date of o9 Certified licator's Signature Date FOR OFFICE ONLY Fisheries Staff Specialist D Approved 1:1 Disapproved Environmental Staff Specialist Approved Disapproved Mail check or money order in the amount of $5.00 to: DEPARTMENT OF NATURAL RESOURCES DIVISION OF FISH AND WILDLIFE COMMERCIAL LICENSE CLERK 402 WEST WASHINGTON STREET ROOM W273 INDIANAPOLIS, IN 46204 P t•'V Jr< cresvtaa Im �E .�n'i ��F'g ti: p a G�..!n ,N U�� Silr:tY j•r IIm� a ,f r p. ..,e L v 'xv� a,� yi ,A "aY a /'�'tS�O�A k��A�:'♦ "i' �s' t♦: q •1� b pol. '+,..x� i A 1 aY `N l L, ,iik, rig R` `.C..' g t 3l aY �t�c �y3 1 -c� a�o J.. p'. a:7 Y�� t$��,1Y F;p4 r., ♦11' 'r 4 ?e'r� o va tai I .I P et 'fT S� �'��.,.`1�L C ?1• u�k 9.._�' 1 I ,ta'T �I'� \C y .r �i,, ?•7. v ;f.> C iz •i �4�• g'v IE ��.:i. 3e=:v t a- "3ap1 °1.1 i•� i ?n;u..<�. .1 rk to ri ♦�a 1, �1 sq;�` OW ICY /f7" ��n t: �IAa YRtiP saLY ATTma�`.6 p y M1 .ta'� J `y y r.�si i ��11� �aay. ;ft�Ap u •.t. _l� a... G., 3t.. .,X�' r�' p II J g c I `1 �1�� Ili I I�,� I ,�Q� Div+ .......UII o�v� v`a• A �A aOrt .�9 naavi♦r S AV f5 p ls RN -�:e'= .•♦•cam- e► =,..c n_`r•`''r� ±c „y'• ACCOUNTS PAYABLE VOUCHER CITY OF CARMEL An invoice of 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 Department of Natural Resources Purchase Order No. Division of Fish and Wildlife Terms Commercial License Clerk 402 West Washington St., Room W273 Indianapolis, IN 46204 Invoice Invoice Description Date Number (or note attached invoice(s) or bill(s)) PO Amount 9/28109 Permits Vegetation control permits 10.00 Total 10.00 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. Department of Natural Resources Division of Fish and Wildlife Allowed 20 Commercial License Clerk 402 West Washington St., Room W273 Indianapolis, IN 46204 In Sum of 10.00 ON ACCOUNT OF APPROPRIATION FOR 101 -General Fund PO# or INVOICE NO. ALCCT #JTITLE AMOUNT Board Members Dept 1125 Permits 4350400 10.00 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 7 -Oct 2009 Signature I 10.00 Accounts Payable Coordinator Cost distribution ledger classification if Title claim paid motor vehicle highway fund