Town of Washburn

STATE OF WISCONSIN
TOWN OF WASHBURN
BAYFIELD COUNTY

 

This Fireworks Display Permit is issued to: (Group)                                                                                                         

 

Address:                                                                                                                                                                            

 

Group or Sponsors of the Display:                                                                                                                                    

 

Date and Time of Display:                                                                                                                                                 

 

Location of Display:                                                                                                                                                           

 

Type of Fireworks:                                                                                                                                                             

 

 

This permit authorizes possession and use of fireworks solely for the fireworks display specified herein, and is not transferable.

Signature of local official authorized to issue fireworks display permits:

 

Town of Washburn Chairman:                                                                                       Date:                                   

 

 

 

NOTE: See s. 167.10, Wis. Stats, for other fireworks regulations. A copy of the permit shall be given to town fire or law enforcement official

At Least 2 Days Before

the date of authorized use. The bond, or liability policy, if required, and a copy of the permit must be filed in the office of the town clerk.