HomeMy WebLinkAboutBurn Permit - 4/97
'7vl ec ( (
Name ~ a. Y'O lei SIc.. \:="s crY-""
Address) iRo S J ~OY'-thl.J.X30& W
City ~ ~ 01 "" ~ State~ Zip. c;.s--5"'0 -
Telephone Number l t) \ ?-. - t.\ 4- r - L( '6 <.{ D
-1. ~~C~ ~ 5
'BURNING PERMIT FOR SCOTT COUNTY ~,f.... 1//1::'1)
8
BURNING PERMIT CONDmONS (Check th"'~~;
D PILED MATERIAL (Circle Fuel) Trees / Brush / Leaves / Other
(Specify) KVlLS h
# Piles _ l
Approx, Pile Size S')(' ~. (
PERMITTEE INFORMATION
a RUNNING FIRE (Circle Fuel) Brush / Slash / Grass
Size of Area in Acres
BURN SITE LOCATION
D FARM OPERATION Household / Other (Specify)
Township
/"\
~& Vl\ c..
o SPECIAL CONDITIONS
Address
City
o ATIACHMENT
a WETLAND
EFFECTIVE DATES:
DAILY HOURS:
I
.f /1
From: M '7 JP "7 N
From: -7- A~M
-
"" ~ r-- .6:' .'1h'
// To: M ~7 IDJ4-N / '/
To: '7' A~M...J OR a ALL DAY
This permit is valid for open burning as allowed and specified in Minn. Rules 7005.0705 to 7005.0805, MS f-/6, 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.
I attest, by my signature, that I have read and will comply with the condrrOtio of, and any attachmentS;jO~h' ermit; and that I am the
Ian. downer or have permission of the landowner t.o burn at the above bur i e locationt1;
, 7 /J
#~ ~ q-<rs--Cf7 ~ ~ I ~~ ;/g-/7
tf'ermittee's Signature Date '1\ prp<;mg Authority Sjtfiature >=. / Date
::I!iiiij:iill:~(!~!!!::Ii..lj:llill!!t!!I!.!II:"l~::'~~::!;'::~:l~~~:iij:iiiiia:j!ij:!tifi.ii:i:i:::i~:~:::~:~:::::I::~:i'::!:::::!:::!:!:~:!:!:::!:I!::I:j:~:I;:;:;:;:;;:i:::i:i:::::i:::III!i::::;:::;::::II:::!I::l
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 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 as provided under Minnesota Statutes 17.135.
. To extinguish the fire immediately ifthis {>ermit is revoked.
· To have this permit available at die burn SIte for inspection.
· That prevailing wind JIlpst be away from nearby occupied buildings.
· That fires will not be allowed to smolder without flame.
PROffiBITED MATERIALS ARE: oils, rubber, p'lastics, tires and chemically. treated materials such as railroad ties
treated .Iumb~rl composite shingles, tar paper, insulation, composition board, sheet rock, wiring, paint, hazardous and
mdustrIal solIa waste.
VIOLATIONS OF PERMIT CONDITIONS MAY SUBJECT PERMI IlhE TO CRIMINAL AND/OR CIVIL
ACTIONS.
REUSE, RECYCLE, AND COMPOST
BURNPRMT.DOC
Revised 4f2J96