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3. 

6. **IF YOUR 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. Temporary Consumer Fireworks Stand Fire Inspection Checklist
    Fireworks Stand Fire Inspection Checklist

    Please download the Fireworks Stand Fire Inspection Checklist to use as a reference for complying with all fire codes to be inspected. Fireworks stand must be ready for business before an inspection can occur.

14. APPLICANT NAME*
15. APPLICANT PHONE NUMBER*
17. APPLICANT EMAIL ADDRESS*

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

19. BLASTING COMPANY NAME
20. BLASTING COMPANY ADDRESS
22. PERMIT SITE CONTACT
23. PERMIT SITE CONTACT PHONE NUMBER
25. BUSINESS NAME

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

26. BUSINESS PHONE NUMBER
28. PERMIT SITE STREET ADDRESS*
30. PERMIT SITE ADDRESS CITY*
31. PERMIT SITE ADDRESS ZIP CODE*
33. DATES AVAILABLE FOR PERMIT / SITE INSPECTION*
    DATES AVAILABLE FOR PERMIT / SITE INSPECTION Start Date

    —

    DATES AVAILABLE FOR PERMIT / SITE INSPECTION End Date

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

34. PERMIT / SITE INSPECTION TIME*

    1. 10:00am - 12:00pm
    2. 1:00pm - 3:00pm

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

36. COMMENTS:

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

Leave This Blank:


40. 1. Receive an email copy of this form.
41. Email address

    This field is not part of the form submission.

42. Submit

* indicates a required field