Kentucky Department of Agriculture
Division of Regulation and Inspection
Amusement Rides and Attractions Inspection Section
107 Corporate Drive
Frankfort, Kentucky 40601

OFFICE:  502/573-0282                                                                          FAX:  502/573-0303    


 I T I N E R A R Y
P E R M A N E NT  F I X E D  L O C A T I O N S    
Amusement Name:
Physical Location:  
City: State:   Zip:
Phone: County:
Contact Person:
Contact Phone Number:
Season Open Date: Close Date:
Date You Need to be Inspected on (Prior to Opening Date):
Special Opening Dates other than above:
Notes:
Signature Owner/Lessee(typing your name is your digital signature):                    Date
                                                              

Email Address:


CHANGES CAN BE MADE BY WRITING A 14 DAY NOTICE PRIOR TO OPERATION AT THIS SITE or by calling 502/573-0282.
KRS 247.234 - 247.236 AND KAR 16:010 - 16:080