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.