HomeMy WebLinkAboutBurn Permit - 2/97
!:/~c f '2..
'1:'"8 "'f:II/~~
BURNING PERMIT FOR SCOTT COUNTY ..&t 2." 19..97
. ''''O'Qr ""'"
BURNING PERMIT CONDITIONS (Check those that apply) " .':
PERMITTEE INFORMATION
Name~. ~~":0~
Address ~_.( rr:es:.-l-
City ( ~f);: kk r Stat~ 1\ ZiPSI)~ 7:J
\.,
Telephone Number J.-l q , 4; ..j)-J 1 ~
BURN SITE LOCATION
Township
Lrnrt
e:/~
Address
Cily
~ ...~--
EFFECTIVE DATES: From: M~ fDcr-.5IY!}$.
DAIL Y HOURS: From: 7rA~
~ILED MA TARIt\L (. Cirrrle Fuel) Trees / Brush / Leaves / Other
(Specify) <' 17>1' 1/ c:.> "-
# Piles l' ~ Approx. Pile Size l () 'f J ~
o RUNNING FIRE (Circle Fuel) Brush / Slash / Grass
Size of Area in Acres
o FARM OPERA nON Household / Other (Specify)
o SPECIAL CONDITIONS
o ATTACHMENT
o WETLAND
-? '< --
To: M ~ fD ~~ IY"
To:~A~ OR 0 ALL DAY
This permit is valid lor 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
during the dates and times listed above.
r attest, by my signature, that I have read and will comply with the conditions of, and any attachments to this permit; and that 1 am the
landowner or have permission olthe landowner to burn at the above bum site locatiun.
(Z:)~n.~,Lt') t",,1Mn fJ -:J1-C/7 ~L -() 1701:-'-1 ,9-.2~ 97
--1e~tteeYs Signature Date Approving Authori&:ture / Date
:1~i!~i::ii~~~::~igl::I!HI:::IHjjitil~:it:::!I:ItI:I~~::tli:::~!!::igi:::!~ig9!is::!9~:::liii:::::::::::~::::'::::~~::::::::'::::::::::::::::::~::::::::,:::::::::::~::::::~:::::::~:::::::::::::::::::::::::::::::::::::::::::::::~:::::,::~
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 exceft as provided under Minnesota Statutes 17.135.
· To extinguish the fire immediately i this permit is revoked.
· To have this permit available at the burn sIte for inspection.
· That prevailing wind IIll!sI 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 .Iumb~r; composite shingles, tar paper, insulation, composition board, sheet rock, wiring, paint, hazardous and
mdustrtal solta waste.
VIOLATIONS OF PERMIT CONDITIONS MAY SUBJECT PERMITTEE TO CRIMINAL AND/OR CIVIL
ACTIONS.
REUSE, RECYCLE, AND COMPOST
BURNPRMT.DOC
Revised 4/2/96