206343 02/14/2012 CITY OF CARMEL, INDIANA VENDOR: 354862 Page 1 of 1
ONE CIVIC SQUARE M I HOMES
CARMEL, INDIANA 46032 8500 KEYSTONE CROSSING, SUITE 190 CHECK AMOUNT: $5,402.00
ATTN: DEE ROBERTS
-�o CHECK NUMBER: 206343
INDIANAPOLIS IN 46240
CHECK DATE: 2/14/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 172.00 REFUND
609 5023990 5,230.00 REFUND
CITY OF CARMEL
2 ITEMS OF 2 PERMIT RECEIPT OPERATOR: nmishler
COPY 1
Sec:29 Twp:18 Rng:03 Sub:LTR Blk:l Lot:21
PARCEL ID ZLTR21
DATE ISSUED.......: 06/22/2011
RECEIPT BC000001719
REFERENCE ID 11060101
n
SITE ADDRESS 2596 WINELAND CREEK DR
SUBDIVISION LAKES AT TOWNE ROAD, THE
CITY WESTFIELD
IMPACT AREA
OWNER M/I HOMES OF INDIANA L.P.
ADDRESS 8500 KEYSTONE CROSSING #190
CITY /STATE /ZIP INDIANAPOLIS, IN 46240
RECEIVED FROM M/I HOMES OF INDIANA
CONTRACTOR D R WATSON CO INC ID- XDRWAT
COMPANY D R WATSON CO INC
ADDRESS 1966 MIDWEST BLVD
CITY /STATE /ZIP INDIANAPOLIS, IN 46214
TELEPHONE
FEE ID UNIT QUANTITY AMOUNT PD -TO -DT THIS REC NEW BAL
USFWATCONN FLAT RATE 1.00 2615.00 0.00 2615.00 0.00
UWATERTAP FLAT RATE 1.00 86.00 0.00 86.00 0.00
TOTAL PERMIT 2701.00 0.00 2701.00 0.00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
CHECK 2,701.00 1454
TOTAL RECEIPT 2,701.00
Prescribed by State Board of Accounts
Form No. 301 (Rev. 1995) ACCOUNTS PAYABLE VOUCHER
TO �1 �v#
ADDRESS
��Z:� �4 y/ cNz �rio5 V4,�L
Invoice Date Invoice Number Item Amount
ex
y�2-w
I 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 exc t
Signature Title
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.
19
Officer Title
Voucher No. Warrant No.
ACCOUNTS PAYABLE DETAILED ACCOUNTS
MUNICIPAL WATER DEPT. A No.
NO.
CARMEL, INDIANA
QS Favor Of
e5,Z�o Kr �/57�►.t� Coss ti� 5�:
Total Amount of Voucher
Deductions c,
J
Amount of Warrant
Month of f
VOUCHER RECORD Acct.
No.
Source of Suppl
Water Treatment I I N
Transmission and Dist. U
Customer Accounts
Administrative and General
Operation-Maintenance
M
Utility Plant in Service
Constr. Work in Progress
Materials and Supplies
Customers Deposits
Total
Allowed
Board of Control
Filed
Official Title
BOYCE FORMS SYSTEMS 1- 800- 382 -8702 325