Q Casino Request for Pyrotechnics Display Request Copyrighted
March 18, 2019
City of Dubuque Consent Items # 14.
ITEM TITLE: Q Casino Requestfor Pyrotechnics Display
SUMMARY: Q Casino requesting approval of a Fireworks Permit
Application for a display of pyrotechnics on April 13, 2019
and April 28, 2019 at approximately 8:00 p.m. for a
performance inside the Q Casino.
SUGGESTED DISPOSITION: Suggested Disposition: Receiveand File;Approve
ATTACHMENTS:
Description Type
Q Casino Fireworks Request Supporting Documentation
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11 WEST 9T". STREET DUBUQUE, IOWA 52001
563-589-4160 FAX 563-589-4209
Permit Application
Date of Application: 2/18/2019
Business, Organization, or
Applicant Name: Q Casino
Contact Person: Jason Kolbe j
Address: 1855 Greyhound Park Road,Dubuque Iowa !
Address of Burn: 1855 Grevhound Park Road, Dubuque Iowa �
Phone Number: 563-585-2966 Fax: �
Cell phone: 608-778-5350 �
E-Mail address jasonk(cr�,qcasinodbq.com
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Type of Permit Requested: (Check one) �
❑ Bon Fire. (1 day) [�Fireworks / Pyrotechnics (1 day) ;
❑ Prescribed Burn (30 day) (City Council Approval Required) '
❑ Land Clearing Burn. (30 day) '
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❑ Agricultural Land Burn. (30day) I�al sting. (30 day)
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Please provide information regarding permit request and event location: '
The Concert dates are Saturday,Apri113t''2019 and Sunday April 28t'`2019 at approximately 8 PM.The �
pyrotechIIics operator on site for the event is Alicia Dove,manager of the Cherry Bombs band.The assistants that are '
inwlved as we are Kelsie Koziol,And Lisa Kapinske both members of the band.The band is professional fire
performers/dancers.They have years of experience using fire fans,fire torches,and palm torches.The permittee's
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insurance carrier is on file with Q Casino and can be forwarded to the Fire Marshall if requested.All fuel will be staged �
outdoors in a double walled container.All clothing is of natural fibers.
Details regarding the permit requirements must be filed when application is made and �
whenever requested by the Fire Marshal. It is the applicant's responsibility to satisfy all j
permit requirements, submit applicable fees with application, and ensure that conditions
are in acc ance wi ap licable State and Local fire regulations. '
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Applicant's Signature i
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ti � FOR DEPARTMENT USE ONLY
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DATE ISSUED:
FEE:$ PAID �
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FII2E MARSHAL
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Pyrotechnics
(Pyrotechnic use will require City Council approval prior to permit issuance)
APPLICATION REQUIREMENTS
• Name of the person,group, or organization sponsoring the production
• Q Casino Dubuque IA
• Date and time of day of the production
• Saturday April 13t", 2019 and Sunday April 28t", 2019 at approximately 8 PM.
• Exact location of the production i
• Q Casino, 1855 Greyhound Park Road, Dubuque IA 52001
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• Name of the person in charge of firing the pyrotechnics (i.e.,the pyrotechnic operator) I
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• Alicia Dove 34, Manager, Cherry Bombs
• Number, names,and ages of all assistants who are to be present
• Alicia Dove 34, Kelsie Koziol 27 and Lisa Kapinske 34. ,
• Qualifications of the pyrotechnic operator °
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• This is not technically Pyrotechnics, but they are professional fire
perfo rmers/da ncers.
• Pyrotechnic experience of the operator - :
• 10+years' experience,safety training on a regular basis. ;
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• Confirmation of any applicable state and federal licenses held by the operator or �
assistant(s}
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• Evidence of the permittee's insurance carrier or financial responsibility
- - - - - - -- ---------•-- Copy on file with Q Casino,copy may be sent to the Fire Marshall if requested— --- ---------- -
• Number and types ofpyrotechnic devices and materials to be used,the operator's
experience with those devices and effects, and a definition of the general
responsibilities of assistants
• Fire fans,fire torches, palm torches, all performers have years of
experience and there are additional fire safeties on each side of stage
including assistants,fire blankets,and fire extinguishers.
All plans shall be submitted as soon as possible so that the authority having jurisdiction has time
to be present and to notify other interested parties. Upon receipt of such application for the
pyrotechnics display,the AHJ should make or initiate an investigation of the site of the
proposed display in order to determine compliance with regulations in the case of the particular �
display. �
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Permit Fee:$ 100.00 plus standby if required �
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Update July 2017 �
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