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HomeMy WebLinkAboutAPPLICATION - 06-00448 - Madison High School - Homecoming Bonfire• ii ~ CITY Q~ ~i•al~sHEd,~ AMERICA'S FAMfLY CUMMUNI`rY 19 E. Main St. Rexburg, Idaho 83440 www.rexburg.org _____ -m. _ --T__ _r ~: Phone: 208-359-3020 x322 Fax: 208-359-3024 cdd@rexburg.org °OPERATIONAL PERMIT" APPLICATION PERMIT $50.00 FEE P ID:,~IE~'"~ PERMITAPPROV/ED: YES/NO BY: DATE• ~ '" l ~ ~ ~~O Owner Information: Parcel Number Owner: _ ,/~c~c~~"S`,n N i~;k Sc4iac l Si-,~~.,t ~c~::3ci 1 Phone Number: ~5Q ~~"3 ~ Owner Mailing Address: ~ ~ Lt 1LLACQ r Z~, n ~i1~ , Property Address: ~ me Cell/Office Number: 35~ -~ ~ 0 ~ Business Name Where Work Will Be Done: Ma~~~'s~^n ~ ~-~>,, Sc~, c~ ~~ ~ Office Address: ~A~*~. Office Phone Number: ~~~ - 3 3 ~ ~j Contact Person: Applicant Information: Name: ,/Utc~ct~s~z,.; I~-Fz:~~ s~-,~::,i SF~~~it C~.;,~c.,~ Name of Business: ti~u~"`5 ~ .~ H ~'~~ >7 S c ~~~~ r~ ~ Address:_ 1~3~1 /~~,~Ll.~su>~ ~-~1~~F Contact Person: ~)ecc~:~b ~u~~; .n PHONE NUMBER: 3~~--3~~ CELL # ~U9 - y37Z Parade Route /Assembly Location: _ l ~ ~~~~ ~ ~~' ~ ~I-c~ ~ftc ~e~'t ion,/( ~"~ I ~,~ (Map required for Parades) SCHEDULE: ~ ~ '~ U / ~~ TO TIME: CI ' V~' ~ ^'~ .___ ~ U ~ 3 C3 ~___.-- a ~3 QC~ PLI S S NATURE D TE Contact Phone #: 1 ., • • Permit # PLEASE CHECKTHE TYPE OF PERMIT S YOU ARE APPLYING FOR: ^ Aerosol product manufacturing List of contents: ^ Combustible dust-producing operations Location: Type of dust: ^ Covered mall buildings Location: ^ Cryogenic fluids Types: ^ Cutting and welding operations Location: ^ Dry Cleaning plants Location: Types of Chemicals: ^ Exhibits and trade shows Location: Type of Fire Extinguishers & Location: ^ Explosives Location: Types: ^ Fire hydrants and valves Locations: Types: ^ Flammable and combustible liquids Types: ^ Floor finishing Types: ^ Fruit and crop ripening Locations: T pes: ^ Fumigation and thermal insecticidal fogging Locations: Types: ^ Hazardous materials Locations: Types: ^ High-piled storage Location: Contents: ^ Hot work operations Location: Dates & Times of Operation: ^ HPM facilities Location: ^ Industrial ovens Location: T pes: ^ Large capacity battery systems Location: T pe: ^ Liquidlgas vehicleslequip. in assembly buildings Location: T pe: ^ LP gas transportation Location: T pe: ^ Lumber yards/plants Location: ^ Magnesium work Location: ^ Misc. combustible storage Location: T pe: ~ Open burning N~Me«,rr~~ Location: ~.,~,.r~ Time & Date: y ua ,o~,.-rv • is ~ ~, ^ Open flames/torches Location: Time & Date: ^ Operating amusement buildings Location: '' ~ 0 Operating aviation facilities Location: ^ Operating carnivals or fairs Location: Dates & Times: ^ Organic coatings T pes: ^ Places of assembly Location: Dates & Times: ^ Private fire hydrants Location: ^ Pyrotechnic special effects material (Fire works) Location: Types: ^ Pyroxylin plastics T pes: ^ Refrigeration equipment Types: ^ Repair garageslmotor fuel dispensing Location: ^ Rooftop heliports Location: ^ Spraying or ipping Location: ^ Storage of combustible fibers Location: T pes: ^ Storage of scrap tiresletc. Location: ^ Temp. membrane structures, tents, and canopies Location: Date 8~ Times: ^ Tire-rebuilding plants Location: ^ UselStorage of compressed gases Location: Types: ^ Waste handling T pes: ^ Wood products Types: Additional Information: