207643 03/26/2012 CITY OF CARMEL, INDIANA VENDOR: 366123 Page 1 of 1
ONE CIVIC SQUARE WEDGEWOOD BUILDING CO
CARMEL, INDIANA 46032 704 ADAMS SUITE A CHECK AMOUNT: $3,496.00
CARMEL IN 46032
o CHECK NUMBER: 207643
CHECK DATE: 3/26/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 86.00 OTHER EXPENSES
609 5023990 2,615.00 OTHER EXPENSES
651 5023990 20.00 OTHER EXPENSES
659 5023990 775.00 OTHER EXPENSES
CITY OF CARMEL
4 ITEMS OF 4 PERMIT RECEIPT OPERATOR: edruley
COPY 1
Sec:21 Twp:18 Rng:4 Sub:GRH Blk:l Lot:7
PARCEL ID 1710210022007000
DATE ISSUED.......: 03/06/2012
RECEIPT BC000002955
REFERENCE ID 12030023
SITE ADDRESS 14551 ALLEN PASS CT
SUBDIVISION GRANDIN HALL
CITY CARMEL
IMPACT AREA
OWNER WEDGEWOOD BUILDING CO., LLC
ADDRESS 704 ADAMS ST, STE A
CITY /STATE /ZIP CARMEL, IN 46032
RECEIVED FROM WEDGEWOOD BUILDING C
CONTRACTOR LUNAR CONSTRUCTION ID- XLUNACON
COMPANY LUNAR CONSTRUCTION
ADDRESS 8121 E 274TH ST
CITY /STATE /ZIP ARCADIA, IN 46030
TELEPHONE (317) 281 -2229
FEE ID UNIT QUANTITY AMOUNT PD -TO -DT THIS REC NEW BAL
USEWERINSP FLAT RATE 1.00 20.00 0.00 20.00 0.00
USFSEWCONN FLAT RATE 1.00 775.00 0.00 775.00 0.00
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 3496.00 0.00 3496.00 0.00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
CHECK 3,496.00 007126
TOTAL RECEIPT 3,496.00
Fre mNo 301 St -S 1995) counts
Far ACCOUNTS PAYABLE VOUCHER
Form No. 301 1995) ,c /l
TO --(AA th LuI.LL)
ADDRESS C7�/ DABS 71 /U- �'`l(e6
Invoice Date Invoice Number Item Amount
�v
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 cept
�3 g am- 1�7
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
SANITATION DEPARTMENT ACCT.
CARMEL, INDIANA
e --,Favor Of
Total Amount of Voucher
Deductions
Amount of Warrant
Month of 19
VOUCHER RECORD Acct. No.
Collection System
Operation
Plant
Commercial V —001
General
Undistributed
Construction
Depreciation Resery e
Stock Accounts Merchandise
Total
Allowed
Board Members
Filed
BOYCE FORMS SYSTEMS 1- 800- 382 -8702 325
CITY OF CARMEL
4 ITEMS OF 4 PERMIT RECEIPT OPERATOR: edruley
COPY 1
Sec:21 Twp:18 Rng:.4 Sub:GRH Blk:l Lot:7
PARCEL ID 1710210022007000
DATE ISSUED.......: 03/06/2012
RECEIPT BC000002955
REFERENCE ID 12030023
SITE ADDRESS 14551 ALLEN PASS CT
SUBDIVISION GRANDIN HALL
CITY CARMEL
IMPACT AREA
OWNER WEDGEWOOD BUILDING CO., LLC
ADDRESS 704 ADAMS ST, STE A
CITY /STATE /ZIP CARMEL, IN 46032
RECEIVED FROM WEDGEWOOD BUILDING C
CONTRACTOR LUNAR CONSTRUCTION ID- XLUNACON
COMPANY LUNAR CONSTRUCTION
ADDRESS 8121 E 274TH ST
CITY /STATE /ZIP ARCADIA, IN 46030
TELEPHONE (317) 281 -2229
FEE ID UNIT QUANTITY AMOUNT PD -TO -DT THIS REC NEW BAL
USEWERINSP FLAT RATE 1.00 20.00 0.00 20.00 0.00
USFSEWCONN FLAT RATE 1.00 775.00 0.00 775.00 0.00
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 3496.00 0.00 3496.00 0.00
METHOD OF PAYMENT AMOUNT REFERENCE NUMBER
CHECK 3,496.00 007126
TOTAL RECEIPT 3,496.00
Prescribed by State Board of Accounts
Form No. 3o,(Rev.1995) ACCOUNTS PAYABL VOUCHER
To D�l� �L)(,.o LL-b
ADDRESS D �o S r
Invoice Date Invoice Number Item Amount
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 except
Sign 4A ture 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. t
CARMEL, INDIANA
avo r r p
0 S �v r7 f
Total Amount of Voucher
Deductions
Amount of Warrant
Month of 19
VOUCHER RECORD Acct.
No.
Source of Su pply
Water Treatment
Transmission and Dist.
Customer Accounts
i
Administrative and General
Operation-Maintenance
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 025