CFD: Fireworks and Pyrotechnic Display Application

Please complete all information; do not leave any spaces blank. Write N/A in spaces that do not pertain to your event.

Applicant’s First Name

Applicant’s Last Name

Applicant’s Company

Applicant’s Phone Number

Applicant’s Email address

Event Information

Event

Event Date(s):

Start Date

End Date

Event Time(s)

Start Time

End Time

Event Location

Setup Date

Setup Time

Inspection

Name of person conducting inspection

Phone Number

Date of inspection

Time of inspection

Written Permission or Notarized Hold Harmless Agreement

Must have written permission from Owner or if City Property must have notarized Hold Harmless Agreement

Upload Letter from Owner of Property or Authorized Representative to Hold Event

Upload requirements

Upload the Notarized Hold Harmless Agreement

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Insurance

Provided Certificate of Insurance

Yes

Upload the Provided Certificate of Insurance

Upload requirements

Aerial Shells and Pyrotechnic Materials

Upload Aerial Shells and Pyrotechnic Materials

Choose files

Upload requirements

List Types

Number

Sizes

Detailed Site Plan

Upload Site Plan

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Included

Parking Area

Roadways

Spectators’ Viewing Areas

Trees

Buildings

Telephone Lines

Other Overhead Obstructions

If other overhead obstructions, please specify

Upload City of Chandler Fire Department Fireworks Supplement Personnel Form

Upload requirements

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CFD: Fireworks and Pyrotechnic Display Application