Blasting Application Form Draft Testing | State Fire Marshal Office

A permit is required to maintain, store, use or handle materials, or to conduct processes which produce conditions hazardous to life or property, or to install equipment used in connection with such activities. The issuance of a permit shall not be construed as authority to violate, cancel or set aside any of the provisions of the code. Such a permit shall not take the place of any license required by law.

Required Documents (attach below)

Copy of current, applicable Alcohol, Tobacco, and Firearms (ATF) License.
Copy of current, applicable ATF listed Responsible Parties, Employee Possessor and/or User Permit(s).
Twenty-Four (24) hour contact information; including name, address, phone numbers, email for responsible parties, local/site Project supervisor or foreman, and primary contact(s) information for the requested permit.
Information on explosive types, quantities in storage, shot quantities and day use estimates.
Purpose of Permit.
Proof of Insurance.
Map of proposed blasting operations and storage magazines (with GPS coordinates identified)
Proof of notification/coordination with local authorities having jurisdiction

Conditions for Approval

Complete application
Attach all required supporting documentation
Submit to Utah State Fire Marshal’s Office

Revocation of Permit

The State Fire Marshal’s Office is authorized to suspend or revoke a permit when

The permit has been used by a person other than the person to whom the permit was issued.
The permit has been used for a location other than that for which it was issued.
Any of the conditions or limitations set forth in the permit have been violated.
The applicant failed, refused or neglected to comply with orders or notices duly served in accordance with the provisions of this code within the time provided therein.
There has been a false statement or misrepresentation as to a material fact in the application or plans on which the permit or application was based.
The permit was issued in error or in violation of an ordinance, regulation or the code.

Please complete the information below, including attaching all of the required documents.

Applicant agency

Contact name

Phone number

Enter your full mailing address

Applicant address

City

State

Zip Code

Blasting site name

Emergency contact name

Emergency phone

Enter the full address (including city and zip code) or GPS coordinates

Blasting site address or coordinates

Proposed start date

Proposed end date

Type full name to sign application

Applicant signature

Date

Copy of current, applicable Alcohol, Tobacco, and Firearms (ATF) License

Copy of current, applicable ATF listed Responsible Parties, Employee Possessor and/or User
Permit(s)

Twenty-Four (24) hour contact information; including name, address, phone numbers, email for
responsible parties, local/site Project supervisor or foreman, and primary contact(s) information
for the requested permit

Information on explosive types, quantities in storage, shot quantities and day use estimates

Purpose of Permit

Proof of Insurance

Map of proposed blasting operations and storage magazines (with GPS coordinates identified)

Proof of notification/coordination with local authorities having jurisdiction

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