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2. Application Date*
   Application Date

   Application must be submitted a minimum of 30 days prior to the event. The application must be reviewed and approved by Vermillion City Council which meets on the first and third Monday of each month. 

3. Required Documents: Proof of Insurance

   Upload Proof of Insurance. If unable to upload the document, please mail it with a completed site plan on the day this application is submitted. 

4. Required Document: Site Plan

   upload a complete Site Plan. If unable to upload the document, please mail it with proof of insurance on the day this application is submitted. Click here for the Site Plan Document.

6. Choose One*

   1. Display Fireworks

   1. Common Fireworks
8. Name:*
9. Email Address:*
11. Address:*
13. City:*
14. State:*
15. Zip Code:*
17. Phone Number:*
19. Exact Location of Event*
20. Event Date*
    Event Date
21. Event Time*
    Event Time Start Time

    —

    Event Time End Time
23. Will City Streets Need to be Closed?

    1. Yes

    1. No

    If "YES," please complete a street closure request. 

24. Click Link for Street Closure Request
    Street Closure Form
26. Information for Person in Charge of Firing the Display
28. Full Name:*
29. Email Address:*
30. Phone Number:*
32. Electronic Signature Agreement*

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

    1. I agree.
34. Electronic Signature*
Leave This Blank:


36. Submit

* indicates a required field