Explosives license

Explosives license application

This license application is for those who manufacture, assemble or wholesale/resale explosives. For those who store for end-use or are an end-user, you must apply for an explosives permit
Name or company name

First Name or Company nameLast Name
Company address*

Street Address

Street Address Line 2

City, CountyState

Zip Code
Company phone number*
Please enter a valid phone number.
Company email*
example@example.com
Responsible party contact information*

First NameLast Name
Responsible party date of birth*

MonthDayYear
Date
Responsible party home address*

Street Address

Street Address Line 2

CityState

Zip Code
Responsible party phone number*
Please enter a valid phone number.
Responsible party email*
example@example.com
Nature of license*

ManufacturerAssemblerWarehouseWholesale/RetailOther
Type of explosives licensed*

High explosivesLow explosivesBlasting agentsPowder onlyOther
Manner of storage*

BuildingIgloo/Army typeTunnel/DugoutBoxesTrailerMagazineOther
Address where explosives are located*

Street Address

Street Address Line 2

CityState

Zip Code
Explosives purchased from

First Name or Company nameLast Name
Explosives purchased from address*

Street Address

Street Address Line 2

CityState

Zip Code
Attach a copy of your ATF license and State or Federal ID such as a drivers license*

Cancelof
The questions below refer to the responsible person listed on this application. If you answer yes to any of the following questions without the certificate* indicated, you are prohibited from obtaining a license.
Are you under 18 years of age?*

YesNo
Have you been convicted of a crime of violence as defined in Minn. Stat. § 299F.72 in Minnesota or elsewhere and not either 1) been restored to your civil rights at least 10 years ago or 2) your sentence expired at least 10 years ago?*

YesNo
Have you been confined to a treatment facility in Minnesota or elsewhere as mentally ill, mentally retarded, or mentally ill and dangerous to the public as defined in Minn. Stat. § 253B.02?*

YesNo
Have you been convicted in Minnesota or elsewhere of unlawful use, possession, or sale of a controlled substance (other than possession of a small amount or marijuana), as defined in Minn. Stat. § 152.01, subd. 16?*

YesNo
Have you been hospitalized or committed for treatment for the habitual use of a controlled substance or marijuana, as defined in Minn. Stat. § 152.01 and 152.02?*

YesNo
Have you ever been confined or committed to a treatment facility in Minnesota or elsewhere as “chemically dependent” as defined in Minn. Stat. § 253B.027?*

YesNo
Minnesota Statutes, Chapter 299F.19 makes it unlawful to store explosive materials in a manner not in conformity with the rules and regulations of the Minnesota Department of Public Safety and the Federal Safe Explosives Act.

By signing below, you are certifying the following information:
- I am the responsible party indicated on this application or, in the case of a corporation, agency, or association, I am authorized to sign this application on behalf of the corporation, agency, or association.
- Under penalties of perjury, I have examined this application and any supporting documents submitted, and to the best of my knowledge and belief, they are true, accurate, and complete.
- I am familiar with the applicable regulations, state laws and rules, and local ordinances relating to explosive and blasting agents for the location intended.
- Prior to the storage or use of explosives or blasting agents, the licensee will notify the appropriate local fire official and law enforcement agency.
Signature*

Clear
Title*
The Minnesota Data Practices Act requires that you be notified of the following information:
- As an applicant for an explosives license, you are being asked to provide private and/or confidential data about yourself that will be used to check criminal histories, arrest records, and warrant information through the Minnesota Crime Information System and local police/sheriff files. This is being done to determine your eligibility to obtain an explosives license.
- You may refuse to provide this information. Should you refuse, this application will not be processed and no license will be issued.
- The information that you provide will be used by the State Fire Marshal to complete its investigation. This information may be conveyed to the Minnesota Bureau of Criminal Apprehension, other law enforcement agencies and treatment facilities identified through this application or investigation.
Please verify that you are human*
Should be Empty:

Explosives license application

The questions below refer to the responsible person listed on this application. If you answer yes to any of the following questions without the certificate* indicated, you are prohibited from obtaining a license.

Minnesota Statutes, Chapter 299F.19 makes it unlawful to store explosive materials in a manner not in conformity with the rules and regulations of the Minnesota Department of Public Safety and the Federal Safe Explosives Act.

The Minnesota Data Practices Act requires that you be notified of the following information: