2010/06/02 Council Agenda Packet

In the space below,draw a diagram of the grounds on which the display is to be held,showing the point at which the fireworks are to be discharged,the location and distance from place of discharge of all buildings, higways and other lines of communication;the placebehind which the audience will be restrained and It's distance from the point of discharge;and the location of all nearby trees,telegraph or telphone lines or other overhead obstructions and their distance from the point discharge. • see attached aeiral showing launch location&fallout setbacks Name of licensed pyrotechnic operator who will supervise discharge of fireworks License no. John Fisher P-02764 Name of assistant to pyrotechnic operator License no. Jim Fisher Proposed display will conform with all the laws and regulations of the State of Washington and the Everett Municipal Code. Permittee shall be responsible for compliance with the provisions under which a public display permit has been granted. Signature of Applicant " " I V Date signed 5/18/2010 Approved by:(Signature of Fire Chief or designee) Date signed (month,date,year) -�<i�::s�:-:r -ris'� -r - �:��. - .b:. s. - --'.�;s<:r,�;=_=z=Y�;;.•.:ru. :?ni=?;��;'':;:'"si;2 ,__. - �a. F; ;; v xy'- _ r OTtGE TO,,/INA CANT•;r. r .� .x_ �� . ., ?,yg��`..va''�s�^�� :��'''„v:&S:��ir�3X-'-��'�.,.�.. .z..,..�..:...^v..�.._4.::�.,�.�.��._.::.4z.S':c'"'.�'{.. Via....��s a,.-.sa'_�i'naxss41;�'i:.:'�_xrv_<:, Your application must be filed with the Everett Fire Department at least 30 days prior to the date of the proposed display. Documentary proof of: Surety bond;public liability insurance;or a director of fire protection's"general license"for the public display of fireworks must be attached to this application. c•+a 3. �g� `� igi' -*j s4 -{• 3' •" � 'i• TC „io.• llnnspecled and�app oved yr .� ��s� u 4 �r Date S a m s ` "lk ..�z?..k �.7er' %..s'` _'`'3 -"'mss=e.t't-Yil''a tMiga- . Yc t i.M.' i A ,�r..,� t.is A k`'�.�;, ,.� � 'r- ��v�r ��•'!�>, i,� 'x:fi r 114