BARTON COUNTY ENVIRONMENTAL MANAGEMENT DIVISION
PO Box 268 - Hoisington, Kansas 67544
(620) 653-2065 telephone, toll free at 1-866-664-2065
BARTON COUNTY APPLICATION FOR RETAIL FIREWORKS LICENSE
INFORMATION TO BE TYPED OR PRINTED
OWNER ______AGE ______
ADDRESS ______PHONE ______
CITY, STATE, ZIP ______
OPERATOR ______AGE ______
ADDRESS ______PHONE ______
CITY, STATE, ZIP ______
STREET ADDRESS OF STAND, IF KNOWN ______
CITY, STATE, ZIP ______
LEGAL DESCRIPTION ______/4 – SEC ______– T ______S – R ______W
APPROXIMATE SIZE OF STAND ______X ______= ______SQ FT
FIREWORKS WILL BE SHADED ______YES ______NO
TYPE AND NUMBER OF FIRE EXTINGUISHERS ______
POSTED “NO SMOKING SIGNS” ______YES ______NO
Complete regulations for the sale of fireworks can be obtained from the Kansas State Fire Marshall Fire Prevention Division, Kansas Administrative Regulations 22-6-1 through 22-6-14. Web site - http://www.accesskansas.org/firemarshal. Kansas State Fire Marshall, 700 SW Jackson, Suite 600, Topeka, Kansas, 66603-3714. Phone (785)-296-3401 – Fax (785)-296-0151.
______
Signed Print Name Date
Return application, along with the permit fee, to the Barton County Environmental Management Division, PO Box 268 Hoisington, Kansas 67544 between 8 a.m. and 5 p.m. Faxed copies will not be accepted.
BARTON COUNTY, KANSAS
FIREWORKS SALE PERMIT ______
______is hereby granted a license to carry on the business or occupation to Retail Fireworks Sales in the _____ /4, Section ______, Township ______South, Range ______West for the week beginning June 27 through 12 p.m., July 4 of 2013.
Issued by Barton County Environmental Management Division, PO Box 268, Hoisington, Kansas 67544, (620) 653-2065 on this ______day of ______, 2013.
FEE ______
______
Barton County Inspector
TO BE POSTED IN A CONSPICUOUS PLACE
BARTON COUNTY, KANSAS
FIREWORKS SALE PERMIT ______
______is hereby granted a license to carry on the business or occupation to Retail Fireworks Sales in _____ /4, Section ______, Township ______South, Range ______West for the week beginning June 27 through 12 p.m., July 4 of 2013.
Issued by Barton County Environmental Management Division, PO Box 268 Hoisington, Kansas, 67544 (620) 653-2065 on this ______day of ______, 2013.
FEE ______
______
Barton County Inspector
TO BE POSTED IN A CONSPICUOUS PLACE
*****
Inspection Date ______Inspected By ______- Initial for pass.
_____ 22-6-2 – Storage – Stored in a room set aside for fireworks storage only. Posted over entrance – “FIREWORKS – NO SMOKING – KEEP OPEN FLAMES AWAY”.
_____ 22-6-3 – Storage – Shall not be kept where paints, oils, varnishes, turpentine or gasoline or other flammable substances are kept, unless in separate and distinct section.
_____ 22-6-4 – Fire Extinguishers – Two approved fire extinguishers must be provided and kept in close proximity to the stock in all buildings. Temporarily erected small stands shall have a fire extinguisher, a barrel of water with at least two buckets or a loaded water hose with nozzle end within fifteen feet of stand.
_____ 22-6-5 – Sale – No sales permitted before June 27 and after July 4.
_____ 22-6-6 – Exposure –
_____ Forbidden to expose through glass, except fireworks in original package;
_____ On front counters must remain in original packages, except where an attendant is on constant duty;
_____ Open stock may be kept in show cases or counters out of the reach of the public without an attendant;
_____ “FIREWORKS FOR SALE – NO SMOKING ALLOWED” shall be displayed.
_____ 22-6-7 – Permitted Fireworks – Class C fireworks only.
_____ 22-6-8 – Storage – Not within fifty (50) feet of any gasoline pump, gasoline filing station, gasoline bulk station or any building in which gasoline or volatile liquids are sold in quantities in excess of one gallon, except in stores where cleaners, paints and oils are handled in sealed containers only.
_____ OTHER – County items
_____ - Application completed in full;
_____ - Calculated size of stand is correct as estimated on application:
_____ - The full fee has been paid.