City of Victoria Form Center

2. 
3. VICTORIA FIRE MARSHAL'S OFFICE

                     9508 Zac Lentz Parkway                                                        Victoria, Texas 77904                                                             361-485-3460

5. Outdoor Assembly Permit Application
7. Applicant Name*
9. Date of Event*
10. Hours of Operation *
12. Event Location Address *
14. How Many Acres*
15. Event Web Site
17. Applicant
19. Contact Person's Name*
20. Email Address*
22. Address*
24. City*
25. State*
26. Zip Code*
28. Phone Number*
29. Fax Number
31. Property Owner
33. Name*
34. Email Address
36. Address*
38. City*
39. State*
40. Zip Code*
42. Phone Number*
43. Fax Number
45. Event Description
47. Event Sponsor*
49. Largest Estimated Daily Attendance*
51. Briefly Describe Your Event*
53. Additional Information
55. Will any of the following be present at the event?
57. Mobile Food Preparation Vehicle?
58. Yes / No
59. Quantity
61. Tents 400 square foot or larger?
62. Yes / No
63. Quantity
65. Temporary special events structures (any temporary structure including stages or towers) ?
66. Yes / No
67. Quantity
69. Recreational Fires?
70. Yes / No
71. Quantity
73. Pyrotechnic Displays?
74. Yes / No
75. Quantity
77. Declaration of Application - Please Read Before Signing
79. I certify that:
81. 1. The information contained in this application, attached plans and specifications, and other attached documentation is true to the best of my knowledge.
83. 2. I agree to conduct operations in accordance with the approved operational permit and all of the documentation submitted and specifications submitted herewith, and in compliance with all of the provisions of the City of Victoria Fire Code.
85. 3. I agree that the Fire Code Official may make as many scheduled and unscheduled inspections as deemed necessary to enforce this Code.
87. Signature of Applicant *
88. Date*
Leave This Blank:


90. 1. Receive an email copy of this form.
91. Email address

    This field is not part of the form submission.

92. Submit Submit and Print

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