208035 04/10/2012 CITY OF CARMEL, INDIANA VENDOR: 366169 Page 1 of 1
ONE CIVIC SQUARE RYAN HOMES
CARMEL, INDIANA 46032 3865 PRIORITY WAYS DRIVE #110 CHECK AMOUNT: $2,701.00
INDIANAPOLIS IN 46240
CHECK NUMBER: 208035
CHECK DATE: 4/10/2012
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
601 5023990 86.00 REFUND
609 5023990 2,615.00 REFUND
CITY OF CARMEL
2 ITEMS OF 2 PERMIT RECEIPT OPERATOR: edruley
COPY 1
Sec:31 Twp:18 Rng:3 Sub:S116 Blk:l Lot:7
PARCEL ID 1609310005007000
DATE ISSUED.......: 02/02/2012
RECEIPT BC000002792
REFERENCE ID 12020005
SITE ADDRESS 4528 GOLDEN EAGLE CT
SUBDIVISION THE SANCTUARY AT 116TH STREET
CITY ZIONSVILLE
IMPACT AREA
OWNER RYAN HOMES
ADDRESS 3685 PRIORITY WAY S DR
CITY /STATE /ZIP INDIANAPOLIS, IN 46240
RECEIVED FROM RYAN HOMES
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 DAL
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 680301
TOTAL RECEIPT 2,701.00
Prescribed by State Board of Accounts
Form No. 301 (Rev. 1995) ACCOUNTS PAYA LE VO CHER
TO ti1 m f5
ADDRESS✓' US ?2 f t�1Lf �7 1� lL
Invoice Date Invoice Number Item Amount
7U tiW 6 il(o
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
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., ACCT.
NO.
CARMEL, INDIANA
Favor Of C
Total Amount of Voucher
Deductions
Amount of Warrant
Month of 19
VOUCHER RECORD Acct.
No.
Source of Suppl
Water Treatment
Transmission and Dist.
Customer Accounts l
Administrative and General
Operation-Maintenance
All
1
Utility Plant in Service
Constr. Work in Progress
Materials and Supplies,
Customers Deposits
I
Total
I
Allowed
r
I
Board of Control
i
Filed j
Official Title
BOYCE FORMS SYSTEMS 1- 800 382 -8702 325