HomeMy WebLinkAboutAPPLICATION - 05-00079 - BYUI Manwaring Ballroom - Fire Permit (2)CITY OF
:"v1�1�R(�.�'S t-�'�'�1iLY C�7,�:�E.�N1�� �` 19 E. Main St. Phone: 208-359-3020 x322
Rexburg, Idaho 83440 Fax: 208-359-3024
www.rexburg,arq cdd@rexburg.oeg
"OPERATIONAL PERMIT" APPLICATION PERMIT #:
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$50A E PAID: YES/NO
BY:
Owner Information: Parcel Number:
Owner: P -D y I (X --- -1
OwnerM2iling Address.
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Property Address:
Business Name Where Work Will Be DonV 114,
Office Address:
Office Phone Number: `t Y(* , Z3 9 7
Applicant Information:
Name:
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Name of Bus`iness: lve_to. 5 4 () V,, d,-L.-��.�.�
Phone Number:
Address: k �oby Iai� #����5 %ekhu,-, T� �i�('�
Contact Person.
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Parade Route lAssembly Location:
(Map regui"red for Parades)
SCHEDULE:
APPLICANTS E
INEXERENANEW1
URE
PERMIT APPROVED: YES/NO
DATE:
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5 Contact Phone #: yqt"2393
PHONE NUMBER: 416-2313 CELL
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DATE
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Permit #
PLEASE CHECKTHE TYPE OF PERMIT
El Explosives
Location:
Types:
El Fire hydrants and valves
Locations:
Types;
u Flammable and combustible liquids
Types:
El Floor finishing
Types:
ii Fruit and crop ripening
Locations:
Types:
C7 Fumigation and thermal insecticidal
fogging
Locations:
Types:
REAPPLYING FOR:
F -A
-� Operating aviation facilities
Location:
[ I
,L -j operating carnivals or fairs
Location:
Dates & Times:
El Organic coatings
Types:
El Places of assembly
Location:
Dates & Times:
El Private fire hydrants
Location:
Pyrotechnic special effects material (Fire works)
Location;
Types:
El Pyroxylin plastics
Types:
El Refrigeration equipment
Types:
11 Repair garages/motor fuel dispensing
Location:
❑ Rooftop heliports
-Location:
Additional Information:
P'sR jt._70-11 '01 yiG +�
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