170575 04/01/2009 CITY OF CARMEL, INDIANA VENDOR: T360754 Page 1 of 1
ONE CIVIC SQUARE PAUL SHOOPMAN HOME BLDR GROUP CHECK AMOUNT: $1,396.00
�lo CARMEL, INDIANA 46032 8227 NORTHWEST BLVD #190
tioH.io INDPLS IN 46278 CHECK NUMBER: 170575
CHECK DATE: 4/1/2009
DEPARTMENT ACCOUNT PO NUM INVOICE NUM AMOUNT DESCRIPTION
601 5023990 86.00 REFUND
609 5023990 1,310.00 REFUND
i
CITY OF CARMEL
Item 1 of 1 PERMIT RECEIPT OPERATOR plux
COPY 1
Sec:29 Twp:18 Rng:3 Sub:LTR Blk; Lot:47
PARCEL ID 1709290016021000
DATE ISSUED.......: 10/17/2008
RECEIPT 29198
REFERENCE ID 08100094
SITE ADDRESS 2525 DIAMOND LAKE DR
SUBDIVISION LAKES AT TOWNE ROAD, THE
CITY WESTFIELD
IMPACT AREA
OWNER PAUL SHOOPP -i N HOMES
ADDRESS 8227 NORTHWEST BLVD
CITY /STATE /ZIP INDIANAPOLIS, IN. 46278
RECEIVED-FROM PAUL SHOOPMAN HOMES
CONTRACTOR LIC XATKIEXC
COMPANY ATKINS EXCAVATING, INC
ADDRESS 8728 N ATKINS WAY
CITY /STATE /ZIP MARTINSVILLE, IN 46151
TELEPHONE (812) 422 -9467
FEE ID UNIT QUANTITY AMOUNT PD -TO -DT THIS REC NEW DAL
USFWATCONN FLAT RATE 1.00 1310.00 0.00 1310.00 0.00
UWATERTAP FLAT RATE 1.00 86.00 0.00 86.00 0.00
TOTAL PERMIT 1396.00 0.00 1396.00 0.00
METHOD OF PAYMENT AMOUNT NUMBER
CHECK 1396.00 4621
TOTAL RECEIPT 1396.00
Prescribed by State Board of Accounts
Form No- 301 (Rev. 1995) ACCOUNTS PAYAB4 VOUCHER
TO �1•ls7o� n�rw �afO
ADDRESS
Invoice Date Invoice Number Item Amount
OAD
4t ,p e� C4 �(o CAD
0—
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 exce
Signa ure 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
N IQ.-cher No. Warra No.
t
ACCOUNTS PAYABLE DETAILED ACCOUNTS
MUNICIPAL WATER DEPT. ACCT.
NO.
CARMEL, INDIANA
t4&0 ?,r a..rFavp�Bfrt 5
t (-k tsxouY 6 ,o
"4 -)Von S ,Lf(o alb
Total Amount of Voucher
Deductions
q( 14 C
I r a C-0
Amount of Warrant (39�
Month of ti` `19
VOUCHER RECORD Acct.
No.
Source of Suppl
Water Treatment
Transmission and Dist.
Customer Accounts
Administrative andtGenera_ I T..
Operation- Maintenance
F' v
Utility Plant in Service L
Constr. Work in Prog
Materials and Supplies
Customers Deposits
Total
Allowed
Board of Control
Filed
Official Title
60YCE FORMS SYSTEMS 1 -600- 382 -8702 325