Fillable BLASTING PERMIT APPLICATION (City of Gallatin)

Fill Online, Printable, Fillable, Blank BLASTING PERMIT APPLICATION (City of Gallatin) Form

Use Fill to complete blank online CITY OF GALLATIN (TN) pdf forms for free. Once completed you can sign your fillable form or send for signing. All forms are printable and downloadable.

BLASTING PERMIT APPLICATION (City of Gallatin)

On average this form takes 8 minutes to complete

The BLASTING PERMIT APPLICATION (City of Gallatin) form is 1 page long and contains:

  • 1 signature
  • 2 check-boxes
  • 29 other fields

Country of origin: US
File type: PDF

U.S.A. forms for City of Gallatin

BROWSE CITY OF GALLATIN (TN) FORMS

Related forms
Fill has a huge library of thousands of forms all set up to be filled in easily and signed.
Fill in your chosen form
Sign the form using our drawing tool
Send to someone else to fill in and sign.
find another form
 
BLASTING PERMIT APPLICATION
Gallatin, Tennessee
Date Applied ______/________/20____
Project Address Suite (if applicable) Subdivision Lot #
Property Owner Mailing Address Phone Email
Agent
Mailing Address
Phone
Email
Blasting Company requesting permit
State Registration #
Company Mailing Address Phone Email
Blaster in Charge
State Registration #
On-site Contact Person
Cell Phone
Years of Experience
Class/Type of Explosives to be used
Location/Distance to Nearest Building:
By submitting this application, I hereby agree that said operations will be carried out in strict compliance with Gallatin Municipal Ordinance
O1605-37, International Fire Code Section 3307, and Tennessee Code Annotated 68-105 (2015) Tennessee Blasting Standards Act of 1975.
Thi
s permit becomes null and void if work or construction authorized is not commenced within 6 months or if construction or work is
suspended or abandoned for a period of 6 months at any time after work in commenced.
In the event the licensed contractor disclosed hereon is replaced on this project, the Gallatin Building Department shall be immediately
notified. Failure to notify may result in revocation of this permit and is a violation of state law.
I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and
ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does not
presume to give authority to violate or cancel the provisions of any other state or local law regulating construction or the performance
of construction. Contractor and/or homeowner/builder is responsible to adhere to all existing setbacks, easements, and/or buffer
yards located on said property.
I hereby certify that I am the:
□ Owner □ Owner’s Agent and all official correspondence in connection with this application should
be sent to my attention using the contact information for myself in the abovementioned.
___________________________________________________________ _________________________________
Print or type name here Date
__________________________________________________________________________________________________________
Signature of Owner or Owner’s Authorized Agent
click to sign
signature
click to edit
Download
Save PDF to desktop
Email
Email completed PDF
Send for Signing
Email for others to sign
Print
Print document
Choose a Field
Click on a field and
select the person that should complete it
Want to add a signature?
You can add a signature field
and assign it to someone else
to sign
Choose a Field
Click on a field and
select the person that should complete it

BLASTING PERMIT APPLICATION (City of Gallatin)

This document is locked as it has been sent for signing.

You have successfully completed this document.

Other parties need to complete fields in the document. You will recieve an email notification when the document has been completed by all parties.

This document has been signed by all parties.

Completed 4 August 2020

Message

View Audit Log
Print With Audit Log
Duplicate Document