HomeMy WebLinkAboutBurn Permit 2005
PLEASE CALL SCOTT COUNTY DISPATCH AT 952-445-1412 THE DAY YOU ARE GOING TO BURN.
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Perm it # I ~
CALL 651-772-7930 NO MORE THAN 1 HOUR PRIOR TO BURNING
BURNING PERMIT FOR SCOTT COUNTY
~ or QMail
PERMITTEE INFORMATION
BURNING PERMIT CONDITIONS (Check those that apply)
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Address jJq f?) f //1{(:> L-/)Ic<- 1 (2.
atyft )OtL L-f\/c-c State \I'll\. Zip S557L
Phone # q) 2. - f.j 9<; -oR J'~
~URN SITE LOCATION
Jii( PILED MATERIAL (Oean Woof:))
(Specify) D CUI 1-.. P )L e.
# Piles -::L- Approx. Pile Size (./ //"-.
to BI./r~
[J RUNNING FIRE (Grassland)
Size of Area in Acres
[J SPEOAL OONDITIONS
~ Township
~ddress
S[\M &-
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EFFECTIVE DATES Fro m: M d... ID:J. flY U~ .
DAILY HOURS From: K{AM)PM
To: M~odf/Y~-
To: C:, A~) OR 0 ALL DAY
This permit is valid for open burning as allowed and specified in Minn. Rules 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
uring the dates and times listed above.
FIRE SAFETY AND AIR QUAU1V REQUIREMENTS
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 perm it.
. 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
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 as provided under Minnesota Statutes 17.135.
. To extinguish the fire im mediately if this perm it is revoked.
. To have this permit available at the burn site for inspection.
. That prevailing wind must b.e away from nearby occupied buildings.
. That fires will not be allowed to smolder without flame.
PROHIBITED MATERIALS ARE: oils, rubber, plastics, tiresand chemically 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 ANDIOR aVIL ACTIONS.
REUSE, REcya...E, 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 landowne: torn at the above burn site location.
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rmittee'sSignature Date Approving ~uthority Signature
-Z/2(,,/o5-
r bate
Paid $25.00 perm it fee ~eCk #
or CJ Cash
Mail form back to:
City of Prior Lake-Burn Permit
16200 Eagle Creek Ave SE
Prior Lake, MN 55372