RAYTOWN FIRE DISTRICT RETAIL FIREWORKS PERMIT 2017 APPLICATION PACKET SUBMIT ALL ITEMS TO: Raytown Fire Protection District 6020 Raytown Trafficway Raytown, MO 64133 816-737-6034 GENERAL INFORMATION This application packet was prepared to aid you in submitting the materials needed for a permit to sell fireworks at retail in the City of Raytown. You must contact any other jurisdiction where you wish to sell for their specific requirements. Both the state and the local fire marshal regulate the sale of fireworks. Applicable state laws include RSMO 40-3.0, Raytown Municipal Code 6168-09 and the Raytown Fire Protection District ordinance 09-12. Under special circumstances provisions of the 2012 International Fire or Building codes may also apply. We strongly advise all applicants to become familiar with all of the applicable codes that regulate firework sales. If questions arise while preparing the materials, please contact the Raytown Fire Marshal as early as possible using one of the methods or numbers detailed on the cover sheet. No more than ten (10) licenses will be issued for the retail sale of fireworks to “not for profit (NFP)”, religious or community service organizations only. To be considered for the ten (10) licenses, a Retail Fireworks Sales application shall be completed and submitted to the Office of the Fire Marshal. A complete application consists of all items identified in the Submittal Requirements checklist. Information missing or not submitted with the application will result in an incomplete application and the application will not be accepted. Applications to be considered for the ten (10) licenses will be selected by a lottery system. The Raytown Fire Protection District will accept applications from April 1st to May 1nd between 8:00 a.m. and 5:00 p.m. Non-returning (2016) applicants submitting an application will draw a number at random at the time of filing. The Fire District will record the number drawn with the applicant’s application. The names of the applicants will be listed in numerical, sequential order of the numbers drawn the first ten (10) Local Organizations listed will be considered for the ten licenses. On May 6th, all applicants will be notified whether their application is one of the ten licenses awarded. The application Fee ($75 filing fee) must be paid within forty-eight (48) hours of the end of the lottery (“48 hour period”) or the application will be deemed denied and the next applicable application shall be considered in numerical, sequential order as determined by the lottery. Once an application is filed, the information contained therein may not be revised or altered; provided, however, that the identity of an entity and the proposed location may be changed by written request received by the Fire District within forty-eight (48) hours of the filing of the application. Any changes to the application in regards to the location and applicant after the 48-hour period will be deemed denied and the next applicable application shall be considered in numerical, sequential order as determined by the lottery.

All applications selected for the licenses will go through a detailed review by the Office of the Fire Marshal. Out of this review, written comments on the proposed application will be prepared and sent to all parties listed on the application form (via fax) or email. The Fire District will have ten (10) business days from the completion of the lottery to review the initial application and will have five (5) business days to review any revised plans. All proposed sales locations must first receive zoning clearance, which may be obtained from the City of Raytown Community Development office. The stand must be located on a property zoned either commercial or industrial. The submitted application must contain the signature of the city Building Official or it will be deemed incomplete and the next applicable application shall be considered in numerical, sequential order as determined by the lottery. No temporarily licensed stands or signs may be set up before June 27th of the licensed year. It shall be the duty of the licensee to completely remove all temporary licensed stands and signs, and to clear the site where such stand and signs were erected of all debris and trash on or before July 8th of the same year. All tents and electrical shall be inspected and approved by both the Fire District and the Community Development Department prior to occupancy or stocking of merchandise. All vegetation within the tent shall be removed, covered, or treated with a non-combustible material. The use of fire retardant sprays will be accepted as an alternative to this. The retail display and sale of allowed fireworks shall be permitted by nonprofit, religious or community service organizations for the period beginning June 29 and extending through July 4 of each year. The hours of operation shall be from 6:00 a.m. till 10:00 p.m. on each day. Stick rockets, missiles, roman candles, and other items which in the opinion of the Fire Marshal, are deemed as dangerous, shall be prohibited. Every applicant shall provide a narrative description of its security plan to secure the premises when not open to the public, including the evidence of the qualifications of the security guard(s). The following types of signs are prohibited and if found shall result in the loss of sale permit: Search lights, inflatable objects/balloons, pennants, streamers, moving/flashing or animated signs, roof signs, and any type of off premise signage (i.e., a sign not located on the approved property)

REQUIRED SUBMITTAL MATERIALS CHECKLIST The following materials must be submitted at the time of application for a retail fireworks permit o o o o o o o o o

A completed application form. A submitted Missouri State Retail Fireworks License application. A certificate(s) of insurance. Proof of organizational eligibility A $75.00 application fee (or a certificate from the pre-application meeting) A site plan of the proposed site. Including the proposed parking plan. An internal floor plan. (if required - see instructions). Security Plan Property owner’s permission or sales agreements (if required - see instructions).

The following items shall be submitted no later than June 1, 2017. o o o o

A submitted Missouri State Retail Fireworks License. A City of Raytown business license A Copy of the paid real property tax receipt for the proposed sale location for the prior year. $1000.00 permit fee paid in full to the Raytown Fire Protection District.

INCOMPLETE APPLICATIONS AND POSTMARKS WILL NOT BE ACCEPTED

APPLICATION INSTRUCTIONS The following instructions are to assist you in completing your permit application. Headings in these instructions are the same as on the permit application. In completing the application form, be sure to fill in all of the spaces and check all of the boxes that apply. APPLICANT INFORMATION Ø Indicate whether this is a new application or a renewal by a previous permit holder. Provide the name of the applying group, organization or person. Every organization must identify a responsible party for the permit. Enter the name of the person responsible for the permit and subsequent operations. Enter “SAME” if the applicant is also the responsible party. Be sure to provide complete legal names (last, first and middle initial) together with the correct date of birth. Only one application may be filed on behalf of an entity for a particular location, and any additional applications filed on behalf of the same entity for a particular location will not be considered. Only one license can be issued for an application and only one license will be issued for each particular location. APPLICATIONS WITHOUT THIS INFORMATION CANNOT BE ACCEPTED. Ø Provide a mailing address, phone number, fax number and e-mail for the applicant or responsible party from the nonprofit, religious or community service organization. SALES AND STORAGE INFORMATION Ø Indicate the address of the intended sales site. Ø Identify the property owner of the sales location. If the property owner is other than the applicant, provide a written statement of permission for the fireworks sales activity from the property owner with the application. Ø Indicate whether the structure used for fireworks sales will be a stand, a tent or another type of temporary structure. Ø If you are renewing your application and will be setting up just as you did last year we can use your old site plan – provided that nothing has changed. Ø If you are submitting an application for the first time or if something has changed either on the site or in the way you will be selling, submit a new site plan. THE SITE PLAN MUST INCLUDE: Ø The dimensions of the stand or other structure used for sales (Example8’x16’ plywood stand) or other structure used for sales. Ø The dimensions between the sales structure and adjacent property lines, nearby buildings, roads and access ways, parking and fireworks storage. Ø Clearly indicate where the stand is located on the property and where any necessary barricades will be located. The plan doesn’t have to be drawn to a specific scale but should be neat and readable. Dimensions will be verified on the site at the time of inspection. Ø If you intend to use a tent or other structure where customers will be allowed inside you must prepare and submit an interior layout plan. Ø Include a proposed parking plan, allowing nine feet per car. Ø Include proposed means for restroom facilities.

THE INTERIOR SITE PLAN MUST INCLUDE: Ø A diagram of the interior layout of the sale area Ø A minimum of forty four (44) inch wide unobstructed the length of the stand, inside and behind the sales counter shall be provided. Ø Each stand up to 24 feet in length or width shall have at least two marked exits; any stand in excess of 24 feet shall have three marked exits. THE SECURITY PLAN MUST INCLUDE: Ø The stand/tent shall be secured and a guard present any time the business is not open to the public. Ø The security guard shall be properly and validly licensed pursuant to the City Ordinance.

OTHER INFORMATION (Submit with your application) Ø Include the certificate of insurance with your application. You must procure and maintain a policy or policies of general public liability, bodily injury and property damage insurance from an approved insurance company in the amount of at least one million dollars ($1,000,000) per occurrence and a two million dollars ($2,000,000) aggregate; the insurance must cover both the sales and storage locations. Ø Include the seventy-five dollar ($75) application fee, checks may be made payable to “Raytown Fire Protection District”. Ø Include proof of a submitted Missouri State Retail Fireworks License application. Ø Include name of licensed wholesaler providing your sales location with fireworks; and the wholesalers contact information (address/telephone). CERTIFICATION Read, sign and date the application at the bottom of the certification section. In the case where a group is the applicant, only the responsible party’s signature is needed. Where the applicant is also the responsible party, only the applicant’s signature is needed. Where there is an applicant and a responsible party, both signatures are needed. SUBMITTAL TIME FRAMES All required information must be received by the Fire Marshal prior to 5:00 PM on May 1, 2017. Original applications may be delivered in person or mailed to the Raytown Fire Protection District, 6020 Raytown Trafficway, Raytown, MO 64133

POSTMARKS WILL NOT BE ACCEPTED

RAYTOWN FIRE PROTECTION DISTRICT 2017 FIREWORKS SALES APPLICATION APPLICANT INFORMATION 2015 PERMIT HOLDER o YES o NO NAME OF ORGANIZATION

(MUST BE DULY RECOGNIZED CIVIC, CHARITABLE OR CHURCH ORGANIZATION LOCATED IN RAYTOWN, MO)

LOCATION SAME AS 2015 o YES o NO

ORGANIZATIONAL RESPONSIBLE PARTY SAME AS 2015 o YES o NO ORGANIZATION MAILING ADDRESS

CITY

STATE

Raytown

MO

PRIMARY PHONE NUMBER

ALTERNATE PHONE NUMBER

ZIP

FAX NUMBER

SALES SITE (ATTACH EXTERIOR AND INTERIOR SITE PLANS TO THIS FORM) PROPOSED LOCATION OF TENT

ZONING CLEARANCE The proposed tent location listed has been reviewed and is compliant with the City of Raytown’s fireworks zoning ordinance.

PROPOSED LOCATION OF FIREWORKS STORAGE

Signature of Community Development Official

NAMES OF ADJOINING PROPERTY WITHIN 300 FEET OF THE SITE (USE ADDITIONAL PAGE IF NECESSARY)

CONTACT NAME AND PHONE NUMBER

STRUCTURE TYPE o o o

TENT TRAILER OTHER TEMPORARY STRUCTURE ________________________________________________

SIZE Length________ ft

Width________ ft

Height________ ft

SALE SITE PERSONNEL Sale of fireworks or operation of a site by any organization or individuals who are not members or employees of the permittee shall void the permit and cause forfeiture of the permit fee. ORGANIZATIONAL RESPONSIBLE PARTY

PHONE

ALTERNATE CONTACT

PHONE

ALTERNATE CONTACT

PHONE

SECURITY PLAN COMMISIONED SECURITY CONTRACTOR

PHONE

APPLICANT CERTIFICATION By signing I certify that: -The information contained in this application is true and accurate to the best of my knowledge. I have read and am familiar with the regulations indicated on this application and contained in Section 19 the City of Raytown Code of Ordinances and the adopted fire code. I understand that failure to comply with any of the regulations of the Raytown Fire Protection District may void the permit and cause forfeiture of the permit fee. ORGANIZATIONAL RESPONSIBLE PARTY SIGNATURE

DATE

ATTACHED ITEMS: o o o o

o o o o

Copy of MO Retail Fireworks License Application Certificate of insurance Proof of organizational eligibility $75.00 application fee or voucher

Exterior & interior site plans Security plan City of Raytown Business License Indemnification form

OFFICE USE ONLY REVIEWED BY

DATE

6020 RAYTOWN TRAFFICWAY, RAYTOWN, MO 64133 PHONE 816-737-6034 FAX 816-737-6049 WWW.RAYTOWNFIRE.COM

LICENSE ISSUED

YES NO

RAYTOWN FIRE PROTECTION DISTRICT RETAIL FIREWORKS SALES INDEMNIFICATION FORM

Indemnity By Applicant: Applicant hereby agrees to indemnify and hold the Raytown Fire Protection District and the City of Raytown, Missouri harmless from and against any and all actions, claims, demands, costs (including reasonable attorneys fees), damages or expenses of any kind which may be asserted against or incurred by the Raytown Fire Protection District and the City of Raytown, Missouri as a result of any occurrence in or about the fireworks sale location, or by reason of Applicant’s operations, or by reason of the failure of Applicant to perform any of its obligations under any federal, state, county, or city statutes, ordinances or regulations pertaining to Applicant’s fireworks operations, or by reason of Applicant’s failure to follow National Fire Protection Association recommendations. Applicant’s Signature: _______________________________________________________ Subscribed and sworn to before me, a Notary Public, this ____day of ____________, 2017. _________________________________________________________________________ Notary Public My Commission Expires: _____________________

Indemnity By Landlord: Landlord hereby agrees to allow the use of their property for the intended purpose of the retail selling of consumer fireworks. The landlord also agrees to accept the responsibility of ensuring the site is returned to its pre-sale condition. Finally the landlord agrees to indemnify and hold the Raytown Fire Protection District and the City of Raytown, Missouri harmless from and against any and all actions, claims, demands, costs (including reasonable attorneys fees), damages or expenses of any kind which may be asserted against or incurred by the Raytown Fire Protection District and the City of Raytown, Missouri as a result of any occurrence in or about the fireworks sale location, or by reason of Applicant’s operations, or by reason of the failure of Applicant to perform any of its obligations under any federal, state, county, or city statutes, ordinances or regulations pertaining to Applicant’s fireworks operations, or by reason of Applicant’s failure to follow National Fire Protection Association recommendations. Landowners Signature: _______________________________________________________ Subscribed and sworn to before me, a Notary Public, this ____day of ____________, 2017. _________________________________________________________________________ Notary Public My Commission Expires: _____________________