HomeMy WebLinkAbout05070116 Application
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CITY OF CARMEL, INDIANA - DEPARTMENT OF COMMUNITY SERVICES I
TEMPORARY USE APPLICATION
FIREWORKS SALES OR SPECIAL EVENT
DIVISON OF BUILDING AND CODE ENFORCEMENT
INCOMPLETE APPLICATIONS WILL DELAY PERMIT REVIEW.
TEMPORARY USE INFORMATION
APPLICANT/ OWNER INFORMATION (PLEASE PRINT OR TYPE) I
COMPANY NAME PIc.. 4 CHIc.. FA~("lS PHONEII (Bi;J.. )9Z<{-,;lSoo I
APPLICANTNAME ()q I.fYHL 1Uf..\JtJ...; s J-. FAXII ( gf,J..) ~ <{ - "5~ t;:, I
ADDRESS OF APPLICANT: I Z- t( \ W (_"-....c.1.. /... "- ()/oo",:",foA ItU In l{o31
..4~6+ec/L~.LA, ::s;O: STATE ZIP CODE I
PROPERTY OWNER NAME fl}-)/!~... g;lt"/o",ft,;//yYlPHONEII ( )
ADDRESS OF OWNER s:r,,9 I t6-, ! I fetb- < <:t , CQ/U).0,,{ STAT!"' Jl} Z~(~E Of.3
SPECIAL EVENT I
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NAME OF BUSINESS/ORGANIZATION:
ADDRESS OF TEMPORARY USE
DA TE(S) OF PROPOSED USE
DESCRIPTION OF TEMPORAR Y USE
HOURS OF OPERATION
WILL THE TEMPORARY USE BE OUTDOORS? ~r NO
WILL THE TEMPORARY USE REQUIRE A STR~~E> (tent, stand, or mobile unit) YES OI:::NO'.--'
IF SO, WHAT TYPE OF STRUCTURE AND INDICATE SIZE iL I ti. O~ -
('NOTE MOBILE UNIT REQUIREMENTS ON BACK') MOBILE UNIT CERTIFICATION II:
WILL THE TEMPORARY USE UTILIZE A TEMPORARY SIGN) YES ~
(' NOTE TEMPORARY SIGN REQUIREMENTS ON BACK') ~
IF APPLICATION IS FOR FIREWORK SALES:
(PLEASE REFER TO ADDITIONAL APPUCA TION REQUIREMENTS FOR FIREWORKS SALES ON BACK)
WILL THE STRUCTURE BE USED FOR THE SALE OF MORE THAN 500 ILBS OF FIREWORKS' YES or NO
DOES THE STRUCTURE ALREADY HAVE A SPRINKLER SYSTEM INST ALLEDI YES or NO
HAS THIS STRUCTURE PREVIOUSLY BEEN USED FOR THE SALE OF FIREWORKS? YES or NO
CERTIFICATION AND NOTICE OF INTENT TO COMPLY
I hereby certify that I have [he authority to make the foregoing application, that [he application and plans filed with the application are
correct, and that the operation and conduct of the temporary use will. conform to the regulations of the Carmel/Clay Zoning Ordinance.
~~liC~ tif ~m'o Prop,cty wnee
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ZONING PARCELII J "1/1-/ D~OO (J 0 60 JO
D E +/ ~/ .D5 PERMIT FEES: I
~M- ~257.50 (Use Permit Fee)
o FIRE DEPARTMENT 0$96.25 (Site Inspection Fec)
0$77.25 (Sign Permit Fcc) 7-
Call (317) 571,2444 to schedule Electrical &:: Site Inspections I"') e:: h
Call (317) 571-2600 to schedule Fire Deparrment Inspection TOTAL FEES DUE: $ ~ I 0 ~
OFFICE USE ONLY (DO NOT WRITE IN)
PERMIT II: -5'
APPLICATION REVIEWED BY:
REQUIRED INSPECTIONS
o ELECTRICAL (B&CE) 0 SITE (PLANNING)
ONE CIVIC SQUARE
DEPAR1MENTOF COMMUNlTY SERVICES
CIIT OF CARMEL, INDIANA
(317)571'2444
~~vice Name:
~evice Manufacturer:
~apacity:
tpeed:
!
Amusement Device Correctio~
Order Form: IC 22.15.7.2
Owner: PIC A CHIC FARMS CATERINd
Inspection Date: 07/15/2005
Device Report 2 of 2
BERRY GO ROUND
SELLNER MANUFACTURING CO
16A20C
6.5
Inspector Badge: 235
Inspection Type: Annual
~ompliance Date:
~learance Date:
TagID:
State Number:
Dated Tag Number:
1626115470
A4212
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#03 lAC 1-5-4
#04 lAC 1-5-6
#05 lAC 1-5-7
#06 lAC 1-5-9
#07 lAC 1-5-10
#08 lAC 1-5-11
#09 lAC 1-5-12
#10 lAC 1-5-14
#11 lAC 1-5-15
#12 lAC 1-5-17
#13 lAC 1-5-18
#14 lAC 1-5-20
#15 lAC 1-5-21
#16 lAC 1-5-22
#17 lAC 1-5-23
#18 lAC 1-5-24
#19 lAC 1-5-27
#20 lAC 1-5-28
#21 lAC 1-5-29
#22 lAC 1-5-33
#23 lAC 1-5-34
l>> #24 lAC 685
#25 Documents
Mfr Man/Maint Rec/lnsp Logs
Devices shall be maint per mfr
Mtl ID tag list:capty,spd,ser #,mfr
Major modification, tagged with info
Repairs, meet or exceed orig equip
Operators : fact sheet
Overload/overspeed : per mfr
Public protection : fenced barricade
Sigl sys/oper/clear view load/unload
Assm/weld:damaged parts/proper tools
Parts/excess wear/damage: not to use
Loctn:blocking/securing/foting/drain
Leveling-alignment:plurnb/level/secur
Access: shall have safe means 2 exit
Lighting: means of access/egress
Emerg brakes / anti--rollback devices
Speed llmiting devices
Machin~tJ guards
Interidt finish: as per manual
Safty:b~lt,bar,ftrst functn per manl
Enclosed structure: load per lBe 675
Relief devices:periodic test per mfr
Elect requirements: comply lBC 675
NO VIOLATIONS AT THIS TIME
Provide written docs upon compliance
>> = Code Violation(s) Cited
;.* = MUST BE COMPLETED BEFORE USE
Comments:
bI-DAYNE NEWQUIST-
Hand Delivered To: DOYLE NEWQUIST
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e of owner/ presentative
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Amusement Device Correction
Order Form: IC 22.15.7.2
Owner: PIC A CHIC FARMS CATERING
Inspection Date: 07/15/2005
Device Report 1 of 2
Device Name:
Device Manufacturer:
Capacity:
Speed:
FERRIS WHEEL
ELI BRIDGE CO
24A/36C
5.5
Inspecto< Badge: 510
Inspection Type: Annual
Compliance Date: 07/25/05
Clearance Date:
TagID:
State Number:
Dated Tag Number:
1626116755
A4829
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#12
#13
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lAC 1-5-3
lAC 1-5-4
lAC 1-5-6
lAC 1-5-7
lAC 1-5-9
lAC 1-5-10
lAC 1-5-11
lAC 1-5-12
lAC 1-5-14
lAC 1-5-15
lAC 1-5-17
lAC 1-5-18
lAC 1-5-20
lAC 1-5-21
lAC 1-5-22
lAC 1-5-23
lAC 1-5-24
lAC 1-5-27
lAC 1-5-28
lAC 1-5-29
lAC 1-5-33
lAC 1-5-34
lAC 685
Documents
Mf< Man/Maint Rec/lnsp Logs
Devices shall be maint per mfr
Mtl ID tag list:capty,spd,ser #,mfr
Major modification, tagged with info
Repairs, meet or exceed orig equip
Operators : fact sheet
Overload/overs peed : per rnfr
Public protection : fenced barricade
Sigl sys/oper/clear view load/unload
Assm/weld:damaged parts/proper tools
Parts/excess wear/damage: not to use
Loctn:blocking/securing/foting/drain
Leveling-alignment:plumb/level/secur
Access: shall have safe means 2 exit
Lighting: means of access/egress
Emerg brakes / anti-rollback devices
Speed limiting devices
Machinery guards
Interior finish: as per manual
Safty:belt,bar,ftrst functn per manl
Enclosed structure: load per IBC 675
Relief devices:periodic test per mfr
Elect requirements: comply IEe 675
NO VIOLATIONS AT THIS TIME
Provide written docs upon compliance
>> = Code Violation(s) Cited
** = MUST BE COMPLETED BEFORE USE
Comments:
DI-DOYLE NEWQUIST-METAL SEAT BOTTOMS RUST.
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Slgnature of Inspector
Hand Delivered To: DOYLE NEWQUIST
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