HomeMy WebLinkAboutBurn Permit - 01/06
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PLEASE CAll. SCOTT COUNTY DISPATCH AT 952-445-1412 THE DAY YOU A!~~lf~Tb ~~. -W J")
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CALL651-772-7930 NO MORE THAN 1 HOUR PRIOR TO BURNING \\Ul ...I'l ' ") ,U U II or OM ail
BURNING PERM IT FOR SCOTT ~ry~ J
PERMITTEE INFORMATION BURNING PERMIT CONDITIONS (Check those that apply)
Nam e ~c:'tt.OVl-t r:'
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~ILED MATERIAL (Oean Wood)
, (~ecjfy) off <k..~A': :<Io.....? ~c},) ___ "
# Piles j Approx. Pile Sze 2?#-
Ad dress i("S-e:. ~ c./.....~ l- /J.-,~
Oty PI\. .'~ L.../i.., State Zip S'Y3'72..
Phone # 9s-z.- '1~'? -Z:i? 955
CJ RUNNING FIRE (G"asslan d)
Sze of Area in Acres
Township Pl1,7...>..., L"i~
Add ress 1~/c-J f)..I[", LIJ. 4~ L
Oty j) 11 :Lt... l-P~
.er:EClAL CONDfTIONV <'/; ~ ~..u..
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BURN SITE LOCATION
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EFFECTIVE DATES: Fro m: ~s2:L!Y (N;
DAILY HOURS From: A VPM
To: M~~Y OfJ
To:--LA~~. OR 0 ALLDAY
. This permit is valid for open burning as allowed and specified in Minn. FaJles 7005.0705 to 7005.0805, MS f 16, Minn. Uniform Rre
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 AGREE:
· To keep this fire under control and to assume responsibility for all damages and coststhat 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 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 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 m us! be away from nearby occupied buildings.
. That fjreswill not be allowed to smolder without flame.
FIRE SAFETY AND AIR QUALITY REQUIREMENTS
.
PROHIBITED MATERIALS ARE: 0 ils, ru b b er, p last ics, t ires an d ch em icaHy treat ed mat erials such as railro ad
ties, treated lumber, composite shingles, tar paper, insulation, composition board, sheet rock, wiring,
paint, hazardous and industrial solid waste.
VIOLA TlONS OF PERMIT CONDI110NS MAY SUBJECT PERMITTEE 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 bur at the above burn site location.
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Perm ille';! Signature Date
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Paid $25.00 perm it fee
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I ( Date
~Oleck # Hit
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or
o Cash
Mail form back to:
City of Prior Lake-Burn Permit
16200 Eagle Creek Ave SE
Prior Lake, MN 55372