ISSUING INFORMATION:
COMPANY NAME:
ADDRESS:
PHONE #: EMAIL:
PERSON CONDUCTING BLASTING:
CELL PHONE #:
DATE OF BIRTH: DRIVERS LICENSE #:
NAME OF ISSUEING COMPANY:
AMOUNT OF COVERAGE $:
AMOUNT TO BE STORED OVERNIGHT:
IF OVERNIGHT STORAGE, TYPE AND LOCATION OF MAGAZINE:
REQUIRED ATTACHMENTS:
* All Applications and Supporting Documentation must be submitted digitally.
* A Permit Fee of $100.00 is Required (Check or Money Order)
Fire Code Official's Signature: Date:
Office of Lee County Fire Marshal
PO Box 1154, 204 West Courtland Drive
Sanford, North Carolina 27331
Phone (919) 718-4670 FAX: (919) 718-4630
DATE OF BLASTING OPERATION:
ATTACHED SITE MAP OF BLATING AREA: (INITIAL)
Fireplans@leecountync.gov
NOTIFICATION TO LEE COUNTY EMERGENCY COMMUNICATIONS IS REQUIRED ONE HOUR PRIOR
TO BLASTING AND AT THE CONCLUSION OF BLASTING EACH DAY. APPLICANT MUST COMPLY
WITH ALL REQUIREMENTS PERTAINING TO EXPLOSIVES IN CHAPRTER 33 OF THE NORTH
CAROLINA FIRE PREVENTION CODE.
ATTACHED PHOTO COPY OF BLSTING CERTIFICATION: (INITIAL)
ATTACHED COPY OF INUSRANCE POLICY OR BOND: (INITIAL)
THIS SECTION TO BE COMPLETED BY APPLICANT
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signature
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signature
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