HomeMy WebLinkAboutBurn Permit - 4/97
~G
Narne4l~ >14d1?~
Address t5?91.!J ~ ;64t~~
City ii",J~Stat~Z~~
Telephone Number <<~~7::Jl')
'BURNING PERMIT FOR SCOTT COUNTY RECEIVE
BURNING PERMIT CONDITIONS (C_h~~PIY)
(J PILED MATERIAL (Circle FUel)~eaVes / Other
(Specify) . J-)
# Piles / Approx. Pile Size h 11'!u~4)
> PERl\'lll 1 EE INFORMATION
[J RUNNING FIRE (Circle Fuel) Brush / Slash / Grass
Size of Area in Acres
BURN SITE LOCATION
Township ~o":' fv,..J:{ (41"1-:)
Address WIIe:Pa ~,,"'"
City C.1tI4~ ~"""p 5r~~,
(J FARM OPERATION Household / Other (Specify)
(J SPECIAL CONDITIONS
D ATTACHMENT
(J WETLAND
EFFECTIVE DATES: From: M.fl-ID~ CJ7 To: M~/D.LiLIY-.!Ll
DAILY HOURS: From: ~~ AM/Wft' To:_<L-AMlPM OR (J ALL DAY
This permit is valid for open burning as allowed and specified in Minn. Rules 7005.0705 to 7005.0805, MS fl6, 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.
1 attest, by my signature, that I have read and will comply with the conditions of, and any attachments /JhiS permit; and that I am the
1Q:;l?imlaM~:::;;~emu7J~i~ +A-97
~c;6nittee's Signature Date Appro~n ~uthority Signlliure I Date
, J
t/ FIRE SAFETY AND AIR QUALITY 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 permit.
. To attend this fire until completely extinguished.
. Not to bum if there is a practical alternatIve method for disposal ofthe 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 bum paI?er or cardboard except as provided under Minnesota Statutes 17.135.
. To extinguisb the fire immediately if this permit is revoked.
. To have this permit available at the bum SIte for inspection.
. That prevailing wind DlllSt be away from nearby occupied buildings.
. That fires will not be allowed to smolder without flame.
PROHIBITED MATERIALS ARE: oils, rubber, p'lastics, tires and chemically' treated materials such as railroad ties
treated )umb~rl composite shingles, tar paper, insulation, composition board, sheet rock, wiring, paint, hazardous and
mdustnal soha waste.
VIOLATIONS OF PERMIT CONDITIONS MAY SUBJECT PERMI 11 bE TO CRIMINAL AND/OR CIVIL
ACTIONS.
REUSE, RECYCLE, AND COMPOST
Revised 4I1J96
BUIlNPRMT.DOC