Low Hazard Fireworks Permit

County of Forty Mile No. 8 Consumer (Low Hazard) Fireworks Discharge Permit
Applicant’s Name*
Over 18 years of age
Address*

Address

Street Address Line 2

CityState / Province

Postal Code
Telephone Number:*
Evening
Telephone Number:
Daytime
Date of Consumer Fireworks Display*

MonthDayYear
Date
Alternate Date of Consumer Fireworks Display*

MonthDayYear
Date
Description of the Site*
List type and kind of Consumer Fireworks being discharged*
Proof of the written authorization of the lawful owner or occupier of the property that Consumer Fireworks may be discharged on his or her property attached, if applicable
Every person who discharges Consumer Fireworks shall be mindful of their duty of care to individuals and property, and shall provide the following for set up:
an open area away from buildings, vehicles, overhead obstructions, and dry brush / grass,a minimum clear area of 30 metres x 30 metres for aerial family fireworks and a minimum clear area of 20 metres by 20 metres ground based family fireworks.fully operational fire extinguishing equipment ready and accessible at all times when family fireworks are being discharged and for a reasonable period thereafter.a hard, flat, level surface for ground based Consumer Fireworks to ensure stability of the item,a means to bury aerial Consumer Fireworks to half their length in the ground or other means,a means to keep all spectators at least 20 metres away,before discharge, the responsible person will read the instructions, cautions and warnings on each Consumer Fireworks item, light only one firework at a time, wear proper eye protection and clothing, keep children away from fireworks, use care when handling and firing fireworks and clean up after the display.
By signing this application you agree to be bound by the commitments made in the application and to have them form conditions on the permit issued.
Signature*

Clear
Date*

MonthDayYear
Date
County Fire Chief Signature

Clear
Date

MonthDayYear
Date
Return application by mail, fax or email to:

County of Forty Mile No. 8

Box 160, Foremost, Alberta T0K 0X0

Fax: (403) 867-2242

Email: firechief@fortymile.ab.ca

**Wind conditions 45 kilometres per hour or higher voids this Consumer (Low Hazard) Fireworks Discharge Permit
Should be Empty:

County of Forty Mile No. 8 Consumer (Low Hazard) Fireworks Discharge Permit