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Fireworks Permit Application

  1. APPLICATION FOR THE DISPLAY OF FIREWORKS PERMIT

  2. Note:

    This entire application must be completed and submitted with the *required documentation or it will be REJECTED.

  3. Applicant information:

  4. Note

    You may enter more than one phone number but you must enter the one you selected as primary. Please include the area code

  5. Display is:

  6. Permit Type:

  7. Sponsor information (if applicable):

  8. Note:

    Missouri State Statute (RSMo 320.126.4) requires all fireworks displays "shall be supervised, managed, or directed by a Missouri licensed operator or pyrotechnic operator on site."

  9. If multiple display dates and/or times at same location by same applicant, please see below for instructions on attaching a list of additional displays including the date and time of each event.

  10. Rain date must be scheduled when application is submitted. Rain dates must be scheduled within 30 calendar days of the permit expiration date.

  11. List the name, ages and emergency phone numbers of all operators and assistants who will be present at this display:

  12. Please attach the following:

    *Required documents must be received 10 days prior to show.

  13. *Any items too large to upload must be submitted in person.

  14. If multiple display dates and/or times at same location by same applicant, please attach list of additional displays including the date and time of each event.

  15. The operator shall be responsible for the retrieval, removal and disposal of an live "dud" shells.

    Permits are issued after payment has been received but are NOT VALID until the Fireworks Display Inspection Checklist has been approved by the Fire Marshal or a Fire Department Representative. This application must be received a minimum of 10 days prior to show. It is the requestor’s responsibility to submit to the Fire Department a valid and current insurance policy upon the expiration of any previous policy prior to the next scheduled event or the permit will be voided.

  16. Signature*

  17. Leave This Blank:

  18. This field is not part of the form submission.