Fireworks Permit Application

2. Applicant Name*

4. Address*

6. City

7. State

8. Zip Code

10. Phone Number*

11. Email Address*

13. Name of organization applying for permit to explode fireworks:*

15. Name of person or organization that shall be the operator or operators of exploding the fireworks:*

17. List previous experience of the operator or operators in exploding the fireworks:*

19. Has the operator or operators had any training in exploding fireworks?*

    1. Yes

    1. No

21. If so, what has this consisted of?

23. Date(s) on which the fireworks display shall take place:*

25. Location at which the fireworks shall be exploded:*

27. City

28. State

29. Zip Code

31. Will any emergency medical treatment be available at the location of where the fireworks will be displayed?*

    1. Yes

    1. No

33. If so, what will this consist of?

35. Will any fire protection be available at the location of the fireworks display?*

    1. Yes

    1. No

37. If so, what will this consist of?

39. Will you notify your local fire department regarding the date, time, and location of the fireworks display?*

    1. Yes

    1. No

41. Will any search be conducted after the fireworks display for unexploded fireworks?*

    1. Yes

    1. No

43. Will people be restricted from the area until the search is completed?*

    1. Yes

    1. No

45. Will the location where the fireworks display is conducted be wetted down after the fireworks display?*

    1. Yes

    1. No

47. Will the operator and the permitee be covered by insurance for their fireworks display?*

    1. Yes

    1. No

49. Iowa Code Section
    Iowa Code Section 331.304(9) and Section 727.2, allow fireworks permits but (1) only upon an application made in writing; (2) only to municipalities, fair associations, amusement parks, and other organizations or groups of individuals approved by the County Board of Supervisors; (3) and only when the fireworks display will be handled by a competent operator.<br><br> These two statutes do not allow a County Board of Supervisors to issue a permit to an individual person.

    Iowa Code Section 331.304(9) and Section 727.2, allow fireworks permits but (1) only upon an application made in writing; (2) only to municipalities, fair associations, amusement parks, and other organizations or groups of individuals approved by the County Board of Supervisors; (3) and only when the fireworks display will be handled by a competent operator.
    
    These two statutes do not allow a County Board of Supervisors to issue a permit to an individual person.

51. If your area is under burn ban on the planned date of your fireworks display, this permit is void.

53. Applicant Signature*

54. Date*
    Date

58. Submit Completed Application
    Submit applications by United States Postal Service to:<br> Hardin County Board of Supervisors<br> 1215 Edgington Avenue, Suite 1<br> Eldora, IA 50627<br><br> Submit completed application by fax to:<br> Fax: 641-939-8223<br><br> Submit completed application by email to:<br> Angela Silvey, asilvey@hardincountyia.gov

    Submit applications by United States Postal Service to:
    Hardin County Board of Supervisors
    1215 Edgington Avenue, Suite 1
    Eldora, IA 50627
    
    Submit completed application by fax to:
    Fax: 641-939-8223
    
    Submit completed application by email to:
    Angela Silvey, asilvey@hardincountyia.gov

Leave This Blank:


60. 1. Receive an email copy of this form.
61. Email address

    This field is not part of the form submission.

62. Submit Submit and Print

* indicates a required field