INSTRUCTIONS

1) A Fireworks permit application shall be submitted at least 14 days in advance of the

Display/show.

2) The application submittal must include the following supporting documentation (A-F). You will be given the opportunity to attach your documents prior to submitting your application:

A) Lead Shooter certifications, qualifications and work experience;

B) Certificate of insurance for the specific event, combined single limit of at least $2,000,000

naming the City of Spencer as additional insured;

C) A complete list of all Fireworks devices to be displayed;

D) A detailed site plan, layout plan and safety distances identified;

E) Letter of permission by the property owner or operator to use Fireworks;

F) A fire safety plan.

3) A permit fee of $50 is required if an admission fee is being charged to attend the event (If permit

is denied, the fee will be refunded) Permit will not be issued until the fee has been received.

4) Payment may be made via credit card on the applicaiton form. Look for the "$" button on the left hand side of the page.

Mail permit fee to:

City of Spencer

418 2nd Ave W

Spencer, IA 51301

If you have any questions, please contact the Spencer Fire Chief or Deputy Fire Chief at

(712)580-7240.

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Signature HereMark Stover Will Sign Here

05/01/2024

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