HomeMy WebLinkAboutBuilding Permit 2005
f,~
ktUvIs,.~::> \we.e.ju~
BURNING PERM IT FOR SCOTT COUNTY
Permit #7S"
oCaIl or ~Mail
PLEASE CAll SCOTT COUNTY DISPATCH AT 952-445-1412 THE DAY YOU ARE GOING TO BURN.
CALL651-772.7930 NO MORE THAN 1 HOUR PRIOR TO BURNING
PERMITTEE INFORMATION
BURNING PERMIT CONDITIONS (Check those that apply)
Name (jaV- Y rY\C)\i ^ \ Q \f
Address \LP~LDS LIf\0.L ~~
Oty ?, L . St at p'VJ Zip Sg-Slc17-
'- L\-L\-i- 3q~ ~
'M PILED MATERIAL (Oean Wood)
[\ (~ecify) I ?y cI
# Piles Approx. Pile Size ^ (....... l\
Ph 0 n e #
Q RUNNING FIRE (Grassland)
Size of Area in Acres
BURN SITE LOCATION
o SJEClAL CONDITIONS
Township ...-. _ ~
./ 0-/-
Address ~
Oty
EFFECTIVE DATES From: M
DAILY HOURS From:
ID /Y
AM/PM
To: M
To:
ID IV
AM/PM OR 0 ALL DAY
This perm it is valid for open burning as allowad and specified in Minn. ~/es 7005.0705 to 7005.0805, MS f 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 times listed above.
IA~c:
. To keep this fire under control and to assume responsibility for all damages and costs that may result from
burning done under this permit.
. To attend thisfire until completely extinguished.
. Not to burn if there is a practical alternative method for disposal of the material such as chipping or
composting. ..
. 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 Satutes 17.135.
. To extinguish the fire immediately if this permit 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.
FIRE SAFETY AND AIR QUALITY REQUIREMENTS
.
PROHIBITED MATERIALS ARE: oils, rubber, plastics, tires and chern 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.
VlOLAllONS OF PERMIT CONDI110NS MAY SUBJECT PERM I I I t:I::: TO CRIMINAL AND/OR CIVIL 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.
XPo,mlt#.' .ss,,:::' r '1(P~'5
Approving Authority Sgnature
~ Mail form back to:
or. CaS~h City of Prior Lake-Burn Permit
" ~ 16200 Eagle Creek Ave SE
if..>' Prior Lake, MN 55372
Date
P~irl $?5 00 pprm it fee 0 Oleck #
~f1teJl-Ioo mdn!..- a6n1b{)~bJ5
~~~' C
.'61. J'/19 /t;S - r/-}/r