FIREWORKS/PYROTECHNICS DISPLAY APPLICATION

What are you applying for? (required)

APPLICANT INFORMATION

Full Name (required)

Phone (required)

Address (required)

Are you 18 or older? (required)

Yes

Colorado Pyrotechnic Display Operator License (required)

Usage of Property Approval Letter (required)

Layout of Fireworks/Pyrotechnic Display (required)

Copy of Insurance/Liability Policy (required)

DISPLAY INFORMATION

Exact location of proposed display. (required)

Date of Display (required)

Time of proposed display (required)

Manner and place of storage of materials (required)

Give a description of the kind of fireworks to be displayed as well as how many. (Separate the different kinds/amounts with a semicolon) (required)

Are you requesting coverage for fire suppression? (required)

Yes

If you are requesting coverage, what type of apparatus/personnel assistance would be desired?

OPERATOR INFORMATION (if different from applicant)

Name

Phone

Years of Experience (required)

Number of Displays (required)

Locations (required)

OPERATOR ASSISTANT INFORMATION

Name (required)

Is the assistant 18 or older? (required)

Yes

Additional Assistants

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