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CITY OF CARMEl / CLAY TOWNSHIP
IMPROVEMENT LOCATION PERMIT APPLICATION
For: T cmjJOrary Use / 5cructlIrc
Permit #: 05080262
Date: 09/07/2005
PARCEL ID #; 1710220022001000
LOT & SUBDIVISION:
Township?: 18 Zoning: PUD
ADDRESS OF CONSTRUCTION; 5925-A E 146TH CARMEL, IN 46033
PROPERTY OWNER INFORMATION:
Name: RIVERVIEW HOSPITAL
Ph, #: 3177730760 Fax #:
Street Address: 395 WESTFIELD RD. NOBLESVILLE, IN 46060
TENANT INFORMATION:
Name: RIVERVIEW HEALTH PARK
Address: 5925-A E 146TH CARMEL, IN 46033
CONTRACTOR INFORMATION:
Name: RIVERVIEW HOSPITAL
Ph. #: (317) 773-0760 Fax #:
Street Address: 395 WESTFIELD RD.
Email:
NOBLESVILLE, IN 46060
PERMIT TYPE: T-SPECIAL
TEMPORARY USE SPECIAL EVENT
Type of Structure:
Star! Date of Operation:
State Certification #:
Fireworks:
State Fire Marshall Permit # (For Fireworks):
Hours of Operation:
End Date of Operation:
Signage Present:
State Insurance # (For Fireworks):
Special Notes/Conditions:
TEMPORARY USE SPECIAL EVENT -RIVERVIEW HEALTH PARK
TENT 40 X 80, TO BE ERECTED FOR AN OPEN HOUSE EVENT
8/25/05-4:30 - 6:30; & 8128/05 11 :30 - 3:00. TEMP
SIGN ALSO ON SITE. APPROVED BY K.BRENNAN 8/25/05.
. NO NOTES'
Permits for Model Homes, Temporary Sales Offices, and Construction Facilities are valid for a period of eighteen (18) months. Upon written req'uest
to the Department of Community Services, permits may be extended for increments of six (6) months, but may not exceed thirty-six (36) months
total. A fee of $75.00 will be assessed for each six (6) month extension. It is the responsibility of the applicant to apply for the permit extensi~n
prior to the expiration of the permit. The permit fee is $250.00 plus applicable assessed inspections.
Outdoor sales permits will be valid for a period of fifteen (15) days. Applicants may apply for additional permits, which may not exceed a total of
forty-five (45) days of use per property. The permit fee is $250.00 plus applicable assessed Inspections.
Special Event temporary uses will be valid for the period approved at review by the City of Carmel Code Enforcement Officer, which may be no
longer than five (5) days. Upon written request to the Department of Community Services, this permit may be extended one time for a period up to
five (5) additional days. A fee of $75.00 wjlJ be assessed for the approved extension. It is the responsibility of the applicant to apply for the permit
extension prior to the expiration of the permit.
Any model home, temporary sales office! construction facility, outdoor sales use, or special event use operating WITHOUT A VALlO
permit shall be considered a civil zoning violation subject to enforcement action by the City of Carmel.
APPLICANT NAME: JERI
FEES:
CII SITE 96.25
TEMPORARY SIGN
SPECIAL EVENT PERMIT
MONCEL
77.25
128.75
Item
1 of
FEE ID
ICIISITE
SIGN-TEMP
SPECEVENT
1
CITY OF CARMEL
PERMIT RECEIPT
OPERATOR:
COPY #
Sec:22 Twp:18 Rng:04 Sub: Blk: Lot:
PARCEL ID ........: 1710220022001000
DATE ISSUED.......:
RECEIPT #.........:
REFERENCE ID # ....
SITE ADDRESS ......
SUBDIVISION ......:
CITY. . . . . . . . . . . . .:
IMPACT AREA ......:
OWNER ............:
ADDRESS ..........:
CITY/STATE/ZIP... :
RECEIVED FROM ....:
CONTRACTOR .......:
COMPANy.......... :
ADDRESS ..........:
CITY/STATE/ZIP ...:
TELEPHONE .........
UNIT
QUANTITY
FLAT RATE
FLAT RATE
FLAT RATE
TOTAL PERMIT :
METHOD OF PAYMENT
CHECK
TOTAL RECEIPT :
AMOUNT
302.25
------------
------------
302.25
1. 00
1. 00
1. 00
09/07/2005
19687
05080262
5925-A E 146TH
CARMEL
RIVERVIEW HOSPITAL
395 WESTFIELD RD.
NOBLESVILLE, IN 46060
RIVERVIEW HOSPITAL
LIC # RIVEHOS
RIVERVIEW HOSPITAL
395 WESTFIELD RD.
NOBLESVILLE, IN 46060
(317) 773-0760
AMOUNT PD-TO-DT THIS REC NEW !BAL
.
---------- ---------- ---------- ----------
96 .25 0.00 96.25 0.00
77.25 0.00 77.25 10.00
128.75 0.00 128.75 0.00
---------- ---------- ---------- - - - - - -,- - - -
302.25 0.00 302.25 :0.00
I
NUMBER
0016387