Fireworks Display Permit Application

Event
Individual, group, or organization sponsoring event
Operator
Fireworks Supplier
Aerial Fireworks Display
List type with a Diameter of less than 3"
List type with a Diameter of 3"
List type with a Diameter of 4"
List type with a Diameter of 5"
List type with a Diameter of 6"
Ground Displays
#1
#2
#3
#4
#5
Personnel
General Information
1) Display of Fireworks shall comply with the requirements of the National Fire Protection Association Standard 1123 “ Code for Fireworks Display” as referenced in Florida State Statute 791. 2) A diagram of the ground on which the fireworks display is to be held shall be provided. It shall include: a. Location of discharge area(s) b. Required separation areas c. Spectator viewing area d. Location of buildings, roads, overhead obstructions, fire hydrant(s) 3) Proof of insurance from the sponsor and the operator shall be provided. 4) An inspection of the display site shall be scheduled to be completed a minimum of three days prior to the event. Non-compliance with the standard or any other City ordinance may be grounds for denial of the display. 5) Fire department personnel shall be required to be on site for purposes of providing fire protection. The sponsoring organization shall be responsible for paying for these services in accordance with Chapter 95 of the City of Lake Mary Code of Ordinances.
I do hereby agree to the terms of this permit