Application to Discharge Display or Theatrical Fireworks

Application to Discharge Display or Theatrical Fireworks

By-law 600-05

This request is to be forwarded to the Clerk's Department a minimum of four (4) weeks prior to the event.

Fees: $125.00 (non refundable). A convenience fee of $3.75 is applied to the total.

Payment: Online payment is now available. Once you have submitted your form, you can process your payment immediately with a VISA or MasterCard. Someone from the Clerks Department will be in contact with you regarding your application.

Questions: If you have any questions or require assistance, please contact the Municipality at 519-326-5761. 

Applicant Information

Event Information

Please provide a Certificate of Insurance proving General Liability Insurance in an amount no less than $5 million dollars. The Certificate must name the Municipality of Leamington as Additional Insured and contain a clause for Cross Liability.

Please provide proof that the Applicant has a Fireworks Operator Certificate or equivalent.

Declaration

I am the owner or authorized agent of the owner of the above application, and I certify the truth of all the statements and representations in this and all other documents submitted. I agree if a permit is issued not to depart from the plans, routes, specifications or spreading located proposed in this applications. I acknowledge that it is an offence to provide false information or to contravene any conditions contained in the permit, if issued.

Privacy Statement: Personal information on this form is collected under the authority of the Municipal Act 2001 P.S.O. c45, and will be used for the purpose of determining eligibility and issuance of Fireworks Permits. Questions about the collection of this information can be directed to the Manager of Legislative Services/Clerk, Municipality of Leamington, 111 Erie Street North, Leamington, ON, N8M 2Z9. Telephone: 519-326-5761.