Permit Request

3. 

6. **IF THE BLASTING LOCATION IS LOCATED INSIDE THE CITY OF CARROLLTON, THE CITY OF BREMEN, OR INSIDE FAIRFIELD PLANTATION THEN THE FIRE MARSHAL FOR THAT DISTRICT SHOULD BE CONTACTED**

8. TYPE OF PERMIT REQUESTED*
   -- Select One --TENTFIREWORKS STAND (SALES)MASS GATHERING/SPECIAL/EXPOSITION EVENTMASS GATHERING w/ PORTABLE GRAND STANDSBLASTING (Expires in 30 days)BLASTING RENEWAL (additional 30 days)FIREWORKS DISPLAY
10. Blasting Permit Application
    Explosive/Blasting Permit Application

    Please download the blasting permit application before submitting this permit request. Email the blasting permit application to Fire Marshal Harmon at dharmon@carrollcountyga.com.

12. CONTACT NAME*
13. CONTACT PHONE NUMBER*
15. CONTACT EMAIL ADDRESS*

    An email address is required to electronically send the permit upon completion.

17. BUSINESS NAME

    If the permit is offiliated with a business then input the name of the business.

18. BUSINESS PHONE NUMBER
20. PERMIT STREET ADDRESS*
22. PERMIT ADDRESS CITY*
23. PERMIT ADDRESS ZIP CODE*
25. DATES AVAILABLE FOR PERMIT INSPECTION*
    DATES AVAILABLE FOR PERMIT INSPECTION Start Date

    —

    DATES AVAILABLE FOR PERMIT INSPECTION End Date

    Input the dates available for the permit inspection. Please request permit inspections 3-5 business days before the available dates.

26. PERMIT INSPECTION TIME*

    1. 10:00am - 12:00pm
    2. 1:00pm - 4:00pm

    Please select a time slot for the inspection that is most convenient.

28. COMMENTS:

30. **PLEASE SUBMIT PERMIT REQUESTS AT LEAST 5 DAYS IN ADVANCE TO ALLOW FOR SCHEDULING**

Leave This Blank:


32. 1. Receive an email copy of this form.
33. Email address

    This field is not part of the form submission.

34. Submit

* indicates a required field