HomeMy WebLinkAboutBurn Permit 2005
PLEASE CALL SCOTT COUNTY DISPATCH AT 952-445-1412 THE DAY YOU ARE GOING TO BURN.
Perm it #Ji!f-
QCaIl or QMail
CALL 651-772-7930 NO MORE THAN 1 HOUR PRIOR TO BURNING
BURNING PERM IT FOR SCOTT COUNTY
PERMITTEE INFORMATION
BURNING PERMIT CONDITIONS (Check those that apply)
Name ~J?I1R.f( ./). ~hll1..cJ_
Ad d reso/ f(? ~6 :S6JJJr/5MUiJl.~ II-'.
atypri~Me 9.a~e&a/ziPS$'i372
Ph 0 n e # 9'S:A - V l.(.? - 3 :A 3 S-
QL PILED MATERIAL (aean Wood)
(~ecify)
# Piles f Approx. Pile Sze 1# x: I I:>
Q RUNNING FIRE (Grassland)
Sze of Area in Acres
BURN SITE LOCATION
o SPECIAL CONDITIONS
Township
Address ~
~ .---"
aty
EFFECTIVE DATES: From: M
DAILY HOURS: From;
/Y~
OR 0 ALL DAY
This perm it is valid for open burning as aI/owed and specified in Minn. Fdi/es 7005.0705 to 7005.0805, MS f 16, Minn. Uniform Rre
code, and /oca/ordinances. The permittee is granted permission to burn the above described materials at the specified location
during the dates and times/isted above.
I AGREE:
. 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 com pletely extinguished.
. Not to burn if there is a practical alternative method for disposal of the material such aschipping 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 Sat utes 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 ch em 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.
VIOLA nONS OF PERMIT CONDIl10NS MAY SUBJECT PERMllTEE TO CRIMINAL AND/OR aVIL ACTIONS
REUSE, RECYCLE, AND COMPOST
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.
,-:<6-0> ~0-( CL?!3
Date Approving Authority Signature
Paid $25.00 perm it fee D Oleck #f1(;3'b
or
D Cash
Mail form back to:
City of Prior Lake-Burn Permit
16200 Eagle Creek Ave SE
Prior Lake, MN 55372