Town of Angelo Fireworks Permit
Fireworks Permit
Town of Angelo, Monroe County, WI
Please download and print this form, complete and mail to Town of Angelo, P.O. Box 18, Sparta, WI 54656.
Wisconsin statute 167.10 prohibits the use or possession of fireworks, as defined under 167.10 (1), without a users
permit issued by the mayor of a city, president of a village or chairperson of a town in which the possession or use
is to occur. Permits can only be issued to one of the following: A public authority, A fair association, An amusement
park, A park board, A civic organization, Any individual or group of individuals, and farmers for the protection of
crops from predatory birds or animals. NOTE: Permits cannot be issued to a minor; they must be 18 years of age,
under 167.10 (3)(c) & (h).
This fireworks permit is issued to:
(Print the name and address of the public authority, fair association, amusement park, park board, civic organization, individual or group of
individuals or farmer)
Name: ________________________________________________________________________
Address: ______________________________________________________________________
City, State, Zip: _________________________________________________________________
Phone Number: __________________________Contact Name: ___________________________
Date on or after which fireworks may be purchased: ____________________________________
The kind and quantity of fireworks, which may be purchased and used:
(Example) Reloadable aerial shells 1.75″ or less sold in a box with not more than 12 shells and one
launching tube, single-shot aerial tubes, bottle rockets, sky rockets and missiles, ground spinners,
pinwheels and helicopters, flares & fountains, roman candles, smoke and novelty items, multi-shot
aerial devices, or “cakes”, sparklers, catherine wheel, black snakes and strobes, firecracker packs
and other fireworks legally sold to consumers in the state of Wisconsin in the approximate quantity
of less than 100.
Date and time authorized for the use of the permitted fire works:_________________________
_____________________________________________________________________________
Location of the use of the permitted fireworks: _____________________________________
(Insert the physical address i.e. W4555 James Road)
Special conditions: The permit holder is required to verify fire conditions (Burning Restrictions) prior to
detonation by contacting the Wisconsin Dept. of Natural Resources at 1-888-947-2876 or via their website at
dnr.wi.gov/forestry/fire and click on “View Burning Permit Restrictions” The use of this permit requires the above
named individual to comply with Wisconsin Statute 167.10 (A copy of this Statue is available at:
http://docs.legis.wisconsin.gov/statutes/statutes/167/10).
_________________________________
Jim Leverich
Town of Angelo
Chairman
A copy of this permit will be given by the Town of Angelo to the Fire Chief and Monroe County Law
Enforcement and be on file with the Town of Angelo Clerk.