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Application For Permit To Hold A Public Display Of Fireworks

Kawartha Lakes logo Kawartha Lakes Fire Rescue Logo

Type of fireworks:

Consumer Fireworks

Display Fireworks

Application is hereby made in accordance with the provisions of the City of Kawartha Lakes Fireworks Bylaw No 2007-236 by:

Name of Applicant (Fireworks Supervisor)

Address (Including Postal Code)

Telephone:

Cell Phone Number:

Sponsoring Organization:

Location of Display:

Organization Contact Name:

Telephone:

For a display permit to set off fireworks on:

Please enter the month, day and year of the expected firework display.

The expected firework display is expected to start at:

The expected firework display is expected to end at:

Your application will not be processed without the submission of the following documents.

Please note the files must be either a: pdf, doc, docx, xls, xlsx, jpg, jpeg, gif, png or tif and the file size must be under 2MB.

Attach Certificate of Insurance

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Allowed extensions pdf, doc, docx, xls, xlsx, jpg, jpeg, gif, png, tif

Attach Site Plan for the Event

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Allowed extensions pdf, doc, docx, xls, xlsx, jpg, jpeg, gif, png, tif

Attach Written Permission of the Property Owner

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Allowed extensions pdf, doc, docx, xls, xlsx, jpg, jpeg, gif, png, tif

Email address:

Signature of Fireworks Supervisor

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