Retail Sale of Fireworks Permits

The City of White Bear Lake regulates the sale of fireworks within its jurisdiction under Section 1126 of the Municipal Code.  Once an application for Retail Sales and Storage of Fireworks has been made and the product is in place, the White Bear Lake Fire Department, or designee, conducts an inspection of the sales structure or storage structure to determine compliance with federal, state and local requirements. 

Complete this application and submit applicable payment via cash or check payable to, "City of White Bear Lake".  Each fireworks site costs $100.00 to license.

Applicant Information
Fireworks Site(s)
List each site designated for storage and/or sale of authorized fireworks below. Each site listed shall include proof of general liability insurance, bodily injury and property damage insurance in the minimum amount of $1,000,000 single limit, with written notice within ten (10) days prior to cancellation.
Location 1
Provide a sketch layout of the proposed set up of both the sales and storage areas.
Location 2
Provide a sketch layout of the proposed set up of both the sales and storage areas.
Location 3
Provide a sketch layout of the proposed set up of both the sales and storage areas.
Tax Clearance and Insurance

Minnesota Statute Chapter 270C, Section 72 requires the licensing authority to provide to the Minnesota Commissioner of Revenue the Minnesota business tax identification number and social security number of each license applicant. Social security numbers shall be provided on the last page of this application for each license applicant. Under the Minnesota Government Data Practices Act and the Federal Privacy Act of 1974, the City is required to advise you of the following regarding the use of this information.

  1. This information may be used to deny the issuance or renewal of your license in the event you owe Minnesota sales, employer’s withholding or motor vehicle excise taxes;
  2. Upon receiving this information, the licensing authority will supply it only to the Minnesota Department of Revenue. However, under the Federal Exchange of Information Agreement, the Department of Revenue may supply this information to the Internal Revenue Service;
  3.  Failure to supply this information may jeopardize or delay processing of your license or renewal.

Minnesota Statute 176.182 requires local licensing agencies to withhold the issuance or renewal of a license or permit to operate a business in Minnesota until the applicant presents acceptable evidence of compliance with workers’ compensation insurance coverage as required pursuant Section 176.181, Subd. 2., and this information will be furnished upon request to the Department of Labor and Industry to ensure compliance with this Statute.

Workers' Compensation Coverage *
Provide the name of the insurance company with which you have workers' compensation insurance.
Refer to MN Statute §176.041 for a list of excluded employees and use this box to explain why your employees are not covered by Workers' Compensation law. False workers' compensation information may result in a $2,000 penalty assessed against the applicant by the Commissioner of the Department of Labor and Industry.
Files must be less than 2 MB.
Allowed file types: gif jpg jpeg png tif html pdf doc docx ppt pptx.

Unless otherwise indicated, the data in this application will be used to approve your license or permit. Upon approval of the license or permit, the information contained in this application shall be deemed public unless classified as private by State Statute. Private data is available to you and the City or State who need this information to perform their duties, but is not available to the public. You are not legally required to provide this data, but the City may not be able to approve your license or permit if you do not provide it.

You may sign up for “Notify Me” on the City’s website at www.whitebearlake.org to receive email notifications anytime the City posts a Public Notice. Public Notices may contain information relating to Ordinance revisions or updates, which could potentially modify business license fees and requirements.

By signing below, you agree to abide by Section 1126, Sale of Fireworks, in the City’s Municipal code and applicable Federal and State laws; you certify that the above information is accurate and complete; you authorize representatives of the City of White Bear Lake to verify the accuracy and completeness of this information.
Date of Electronic Signature
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