HomeMy WebLinkAboutBurning Permit 3-03
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BURNING PERMIT FOR SCm~l:1NTY ~
PERMITTEE INFORMATION BURNING PE~~ONDITIONS (C.
te:?!t #J2L
~all or OMail
ose that apply)
Name / tJN( of- j) /vl1 ~ NL T
Address 1ft,). r/ tJ/lKt../W.() A'awt /J1$ <
City !Jfdtf. L"r,u: StateM'vZip,,53
Telephone Number 1/ S-:Z - j..1,J -tt.3~
r;{ PILED MATERIAL (Clean Wood)
(Specify) 7/2-GE 11 ,(2/I#~s, .dkJu..s-1/
# Piles / Approx:Pile Size :::;;- /0 y 1(1 /
o RUNNING FIRE (Grassland)
Size of Area in Acres
BURN SITE LOCATION
o SPECIAL CONDITIONS
Township {If 7' IF Alr:),e L.1t'K-€
Address /~ 2-( O~~ 15ElteH I!JVG::,
City PI2{4~ LAKe
EFFECTIVE DATES: From: M
DAILY HOURS: From:
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 bum the above described materials at the specified location
luring the dates and times listed above.
FIRE SAFETY AND AIR TY REQUIREMENTS
~v 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 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 if this permit is revoked.
· To have this permit available at the burn site for inspection.
· That prevailing wind must be away from nearby occupied buildings.
. That fires will not be allowed to smolder without flame.
yPROHffiITED MATERIALS ARE: oils, rubber, p'lastics, tires and chemically' treated materials such as railroad ties
~ treated .lumb~r1 composite shingles, tar paper, insulation, composition board, sheet rock, wiring, paint, hazardous and
mdustnal soh a waste. .
VIOLATIONS OF PERMIT CONDITIONS MAY SUBJECT PERMITTEE TO CRIMINAL AND/OR CNIL
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 rmission of the landowner to bum at the above bum site location.
3-/7-
Date
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Date
Paid $25.00 permit fee ~heck H;J\b1
BURNP&\fl'
or 0 Cash
Revised4.12.01