"Variation Application" - New Jersey

Variation Application is a legal document that was released by the New Jersey Department of Community Affairs - a government authority operating within New Jersey.

Form Details:

  • Released on November 1, 2017;
  • The latest edition currently provided by the New Jersey Department of Community Affairs;
  • Ready to use and print;
  • Easy to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of the form by clicking the link below or browse more documents and templates provided by the New Jersey Department of Community Affairs.

ADVERTISEMENT
ADVERTISEMENT

Download "Variation Application" - New Jersey

Download PDF

Fill PDF online

Rate (4.7 / 5) 48 votes
VARIATION APPLICATION
New Jersey Department of Community Affairs
Carnival Amusement Ride Safety Division
PO Box 816--101 South Broad Street
Trenton, N.J. 08625
609-292-2097--FAX 609-984-7084
N.J.A.C. 5:14A-2.16
OFFICE USE ONLY
DATE APPLICATION RECEIVED
REVIEWING ENGINEER
q
q
VARIATION NUMBER
DISPOSITION OF VARIATION
Approved
Denied
SUPERVISOR SIGNATURE
COMMENTS
OWNER / MANUFACTURERS NAME
ADDRESS
CITY
COUNTY
ZIP
RIDE FOR WHICH VARIATION IS REQUESTED
LOCATION OF RIDE
RIDE CLASS
N.J. I.D.#
TYPE CERT. OR INDIVIDUAL APPROVAL#
MANUFACTURER
MFG. SERIAL #
SECTION OF CARNIVAL AMUSEMENT RIDE ACT FOR WHICH VARIATION IS REQUESTED
REQUIREMENT FROM WHICH VARIATION IS SOUGHT
MANNER IN WHICH STRICT COMPLIANCE WOULD RESULT IN PRACTICAL DIFFICULTIES
Include drawings and engineering calculations when applicable.
PROPOSED ALTERNATIVE TO REQUIREMENTS.
LIST OF ATTACHED DOCUMENTATION PROVING THAT THE VARIATION WILL NOT CREATE A LESS SAFE CONDITION.
SIGNATURE AND TITLE OF AUTHORIZED AGENT
DCACAR-var-(08-01-19)
VARIATION APPLICATION
New Jersey Department of Community Affairs
Carnival Amusement Ride Safety Division
PO Box 816--101 South Broad Street
Trenton, N.J. 08625
609-292-2097--FAX 609-984-7084
N.J.A.C. 5:14A-2.16
OFFICE USE ONLY
DATE APPLICATION RECEIVED
REVIEWING ENGINEER
q
q
VARIATION NUMBER
DISPOSITION OF VARIATION
Approved
Denied
SUPERVISOR SIGNATURE
COMMENTS
OWNER / MANUFACTURERS NAME
ADDRESS
CITY
COUNTY
ZIP
RIDE FOR WHICH VARIATION IS REQUESTED
LOCATION OF RIDE
RIDE CLASS
N.J. I.D.#
TYPE CERT. OR INDIVIDUAL APPROVAL#
MANUFACTURER
MFG. SERIAL #
SECTION OF CARNIVAL AMUSEMENT RIDE ACT FOR WHICH VARIATION IS REQUESTED
REQUIREMENT FROM WHICH VARIATION IS SOUGHT
MANNER IN WHICH STRICT COMPLIANCE WOULD RESULT IN PRACTICAL DIFFICULTIES
Include drawings and engineering calculations when applicable.
PROPOSED ALTERNATIVE TO REQUIREMENTS.
LIST OF ATTACHED DOCUMENTATION PROVING THAT THE VARIATION WILL NOT CREATE A LESS SAFE CONDITION.
SIGNATURE AND TITLE OF AUTHORIZED AGENT
DCACAR-var-(08-01-19)