FIREWORKS/PYROTECHNICS DISPLAY APPLICATION What are you applying for? (required)Fireworks Pyrotechnics APPLICANT INFORMATION Full Name (required) Phone (required) Address (required) Are you 18 or older? (required) Yes No 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 No If you are requesting coverage, what type of apparatus/personnel assistance would be desired? OPERATOR INFORMATION (if different from applicant) Name Phone Email Years of Experience (required) Number of Displays (required) Locations (required) OPERATOR ASSISTANT INFORMATION Name (required) Is the assistant 18 or older? (required) Yes No Additional Assistants There was a problem saving your submission. Please try again later. Please wait while your submission is being saved... Submitting...Submit Thank you, your submission has been received.
