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Fire Safety Permit Application

Name Requiring Permit *

Location of Event *

Event Time *

Location Address *

Location Phone Number *

Applicant Name *

Applicant Home Address *

Applicant Phone Number *

Email Address *

Name of Person Responsible for Activity *

Person Responsible Address *

Person Responsibile Phone Number *

Permit Requested For Following Dates *

Permit Requested For One Year *

Requests Permission to Conduct the Following *

Description of Events *

Storage Occupancy Usage Sale Handling Manufacturing *

State quantities and method for each material *

I hereby acknowledge that the information provided is correct and agree to comply with the applicable requirements of the New Jersey Uniform Fire Code as well as any specific conditions imposed, and if not, this permit may be revoked and I will be subject to penalties as provided by the law.

Acknowledgement * I understand

* - denotes required field

WINSLOW TOWNSHIP FIRE DEPARTMENT

Fire Safety Permit Application