HomeMy WebLinkAboutBurn Permit - 5/03
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/CALL 651-772-7930 NO ORE THAN 1 HOUR
PRIOR TO BURNING
._---- BURNING PERMIT FOR SCOTT COUNTY
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PERMI'ITEE INFORMATION
BURNING PERMIT CONDITIONS (Check those that apply)
Name #fl/2L) f:j h I :"k5~
Address t;/itfJ.5'1 AJtnIbv~ .Pd Mt4
City ?fl"tJr jakf Smte/ill-Zip;-;-;7
K PILED MATERIAL (Clean ~
(Specify) ~-I M
# Piles -> Approx. Pile Size Ju~/-
.
Telephone Number
Cl RUNNING FIRE (Grassland)
Size of Area in Acres
BURN SITE LOCATION
[J SPECIAL CONDITIONS
City
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Township
Address
EFFECTIVE DATES:
DAILY HOURS:
ALL DAY
This permit is validfor open burning as allowed and specified in Minn. Rules 7005.0705 to 7005.0805, MS f16, Minn. Uniform Fire
code, and local ordinances. The permittee is granted permission t9 bUT'}'!.the above described materials at the specified location
during the dates and times listed above. --;0,...-."'''----
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C--' ~ FIRE SAFETY AND AIR REQUIREMENTS
~ 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 frre until completely extinguished.
. Not to burn if there is a practical alternattve 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 extinguisb 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.
PROHIBITED MATERIALS ARE: oils, rubber, ~lastics, tires and chemically' treated materials such as railroad ties
~~eated .1umb~r~ composite shingles, tar paper, insUlation, composition board, sheet rock, wiring, paint, hazardous and
mdustrial soha waste. .
/ VIOLATIONS OF PERMIT CONDITIONS MAY SUBJECT PERMITfEE TO CRIMINAL AND/OR CIVIL
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 h. ave perm;."w. of the kmdowner to burn at the above ~b:': ~~a . ....... .. .
eL~ S-11-~'~. ~--.?'27_cr~ I
lAermittee's Si ature Date ~: vin A . S Date.
Paid $25.00 pennitfee ~eck#~ or I:J Cash
BURNPRMT
Revised 4-12-0 I