All Basting permits will be issued persuant to [IFC} Chapter 56: Explosives and Fireworks; Section 5607: Blasting.

Applicant Organization: (required)

Point of Contact Full Name: (required)

Phone: (required)

Email: (required)

Applicant Address: (required)

Blasting Site Name: (required)

24-Hr. Emergency Contact: (required)

Emergency Phone: (required)

Blasting Site Address/Coordinates: (required)

Proposed Start Date: (required)

Proposed End Date: (required)

Attach ATF License: (required)

Attach Scope of Work & Safety Plan: (required)

Attach Proof of Insurance: (required)

Attach Blasting Site Map: (required)

Your Signature (required)

Confirm e-Signature

Review Electronic Records and Signatures Policy (required)

Read our Electronic Record and Signature Disclosure

I agree to use electronic records and signatures

There was a problem saving your submission. Please try again later.

Please wait while your submission is being saved...

Submitting...Submit

Thank you, your submission has been received.