Permit - Fire Works Display

Notice*
No permit will be issued until $50.00 fee is recieved. Please make checks or money orders payable to "County of Henry" and send to: Henry County Fire Marshal's Office 1024 DuPont Road Martinsville, Virginia 24112
Address of Display Address of Display
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Property Owner Name
Technician in Charge
Technician Address Technician Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Technician Phone Number Technician Phone Number - ### - ### ####
Site Contact Phone Number Site Contact Phone Number - ### - ### ####
Email
Notes
Document Upload

Attach Files

Please upload copies of Background Clearance Card, Proof of Insurance, and Identification Card (i.e. Driver's License)