HomeMy WebLinkAboutBurn Permit 2005
PLEASE CALL SCOTT COUNTY DISPATCH AT 952-445-1412 THE DAY YOU ARE GOING TO BURN.
CALL 651-772-7930 NO MORE THAN 1 HOUR PRIOR TO BURNING
Permit #~
"Call or oMail
BURNING PERMIT FOR SCOTT COUNTY
'ERMITTEE INFORMATION
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BURN SITE LOCATION
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EFFECTIVEDATES From: M:!f /rill; IYfJS-
DAILY HOURS Fro m : 0 (AM7jM
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BURNING PERMIT CONDITIONS (Check those that apply)
(6 PILED MATERIAL (Qean Wood)
(Specify) / t
# Piles f-i- Approx. Pile Size I(J~ (
[J RUNNING FIRE (Grassland)
Size of Area in Acres
IQ SPEa~ COND~TI S D f
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To: M~D~! /Y()'1 ( T ~~,~ ~ "lfm1. -3. p..d .
To /1 A~,lr-(v!> OR [J ALL DAY .
----
This permit is valid for open burning as allowed and specified in Minn. Rules 7005.0705 to 7005.0805, MS 1-16, Minn. Uniform Fire
code, and local ordinances. The permittee is granted permission to burn the above described materials at the specified location
during the dates and tim es listed above.
FIRE SAFETY AND AIR QUALITY REQUIREMENTS
"
I AGREE:
. To keep this fire under control and to assume responsibility for all dam ages and costs that may result from
burning done under this perm it.
. To attend this fire until com pletely extinguished.
. Not to burn if there isa practical alternative method for disposal of the material such aschipping or
com posting.
-. To use a clean burning device to start the fire.
. Not to conduct burning during any air quality alert.
. Not to burn paper or cardboard except asprovided under Minnesota Statutes 17.135.
. To ext inguish t he fire im m ed iately if t his perm it is revoked.
. To have this permit available at the burn site for inspection.
. That prevailing wind must be away from nearby occupied buildings.
. That fires will not be allowed to smolder without flame.
PROHIBITED MATERIALS ARE: oils, rubber, plastics, tires and chem ically treated materials such as railroad
ties, treated lumber, composite shingles, tar paper, insulation, composition board, sheet rock, wiring,
paint, hazardous and industrial solid waste.
VIOLATIONS OF PERMIT CONDITIONS MAY SUBJECT PERMITTEE TO CRIMINAL AND/OR aVIL ACTIONS.
REUSE, RECYCLE, AND COMPOsr
I attest, by my signature, that I have read and will comply with the conditions of, and any attachments to this
permit; and that I am the landowner or have permission of the landowner to burn at the above burn site location.
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--'rmittee'sSignature ..-- " Date Approving Authority Signature
-"L('JJ, rkJ-,
Paid $25.00 perm it fee 0 O1eck # ~( or 0 Cash
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Date
Mail form back to:
City of Prior Lake-Burn Permit
16200 Eagle Creek Ave SE
Prior Lake, MN 55372