2. Application for Fireworks Stand Permit

4. Business Name

   (PTO, PTA, Girl Scouts, Boy Scouts, Campfire Girls and 4H Clubs are not required to collect/pay sales tax)

5. Sales Tax Number
7. Business Address
8. Business Phone
10. Contact 1
12. Name
13. Organization
15. Address
17. City
18. State
19. Zip
21. Home Phone
22. Work Phone
24. Contact 2
26. Name
27. Organization
29. Address
31. City
32. State
33. Zip
35. Home Phone
36. Work Phone
38. Location

    (Location where fireworks will be stored or sold)

40. Owner of Land
41. Land Owner Phone
43. Description of Fire Protection to be Provided

    (Two (2) 4A, 40 BC extinguishers are required)

45. Liability Insurance Company

    ($500,000 general comprehensive liability and product liability insurance is required with the City of El Dorado named as an additional insured. Proof of insurance must be provided.)

46. Policy Number
48. Type of Fireworks to be Stored and/or Sold

    (Bottle and Sky Rockets Prohibited, permitted are Class C, U.N. 1.4 G)

50. Upon approval of the application, a fee of $5,000.00 shall be paid to the City Clerk for a firework permit. A deposit of $2,500.00 shall be made for clean-up of stand site. If site is cleaned up by July 14 this deposit will be refunded.

    Upon receiving the permit the fireworks stand owner and/or operators agree to the following rules and regulations:

    1. Fireworks stands may not commence sales until such a time as they have received a Fire Department inspection and obtained a permit.
    2. Fireworks stands may only be open during the following dates and times:
       1. June 27, 28, 29, 30 July 1, 2, 3 from 08:00 a.m. to 12:00 a.m. (midnight)
       2. July 4 from 08:00 a.m. to 11:00 p.m.
    3. The stand cannot be open or admit people into the stand area until the above listed times. At closing time the tent will be closed and no other customers will be admitted to the stand at that time. Customers in the stand area may complete their purchases.
    4. Fireworks stands must be erected 75 feet away from any structure. Stands must be equipped with a minimum of two (2) ten pound (4A 40 BC) fire extinguishers. One must be mounted inside the selling area and the other must be mounted outside the stand.
    5. Each fireworks stand shall provide no less than one (1) off-street parking stall per 100 square feet of sales structure floor area and adequate ingress and egress aisles. Operators shall provide, without cost to the City, such flag-persons and attendants as are necessary to insure the orderly parking of vehicles around each sale site and shall in no way interfere with the normal flow of traffic on public roads.
    6. No fireworks may be fired within 200 feet of any fireworks stand.
    7. No smoking is allowed within 50 feet of any fireworks stand.
    8. No alcoholic beverages are allowed at any fireworks stand.
    9. Children under 10 years of age must have supervision.
    10. Each stand must be equipped at the main entrance to the stand with a sign at least three (3) feet by three (3) feet in size, which is clearly visible notifying the buyer of the following rules:
        1. All fireworks must be fired on private property.
        2. Fireworks may be discharged only between:
           • 10:00 a.m. to 10:00 p.m. June 27^th – July 3^rd
           • 08:00 a.m. to 12:00 a.m. (midnight) July 4^th
           • 10:00 a.m. to 10:00 p.m. July 5^th
        3. Fireworks are outlawed in Butler County and at the El Dorado State Park.
        4. No fireworks may be fired within 200 feet of any fireworks stand.
        5. No smoking is allowed within 50 feet of any fireworks stand.
        6. No alcoholic beverages are allowed at any fireworks stand.
        7. Children under 10 years of age must have supervision.
    11. Vehicle parking shall not be allowed within 20 feet of tents, canopies or other membrane structures used as fireworks stands. This area shall be clearly identified so as to prevent the parking of vehicles within this area.
    12. It shall be the responsibility of the permit holder and any designated attendants to enforce these requirements.

52. I am aware of the above listed rules and regulations and as a stand owner and/or operator agree to follow these rules and regulations. I understand that any violation of the above rules and regulations can result in a warning by the Fire Chief or his designee. Any second or subsequent violations that may occur shall result in revocation of the permit for sale and terminate the sale of fireworks by the stand found in violation.

54. Signature of Applicant
55. Date of Application

57. Remember to include the following Documentation

59. Certificate of Insurance
61. Site plan/layout of stand and sales area
63. Certificate of flame resistance (if using a tent/canopy)

67. City Hall Use Only

    ___ Approved

    ___ Disapproved

    Reason if disapproved: __________________________________________________________________________________________ ____________________________________________________________________________________________________________________________________________________________________________________________________________________________

    Fire Department Official: ________________________________________    

    Date: ______________________________    License Number Issued: __________________________________

    City Clerk: _______________________________

Leave This Blank:


69. 1. Receive an email copy of this form.
70. Email address

    This field is not part of the form submission.

71. Submit

* indicates a required field