HomeMy WebLinkAboutBurn Permit - 6/02
CALL 651-772-7930 NO MORE THAN 1 HOUR
PRIOR TO BURNING
permit#~
!Jeall or OMail
BURNING PERMIT FOR SCOTT COUNTY
PERMITTEE INFORMATION
BURNING PERMIT CONDITIONS (Check those that apply)
Nom. Ct-2 J. Pi-_
Address I. ;)..()(} ~/L. 0, ~~
City Pc.. _ Stat~ Zip ,r37:l
Telephone Number qr,. V'fr.- l(2"Jtl
CJ PILED MATERIAL (Clean Wood)
(Specify)
# Piles I Approx. Pile Size / t) I<' /f7 I
CJ RUNNING FIRE (Grassland)
Size of Area in Acres
BURN SITE LOCATION
Township C'Tr aR (Jc,(
Address I (p S Cf I 'Lrf....c.. e:.. Ail L
City lr", ~ /( '- P1fl'
IJ SPECIAl-CONDITIO:) ,
~~~tt'~~iA('^I~~
EFFECTIVE DATES:
DAILY HOURS:
IY~
OR CJ ALLDAY
This permit is validfor open burning as aI/owed 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.
\ '
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 ifthere is a practical alternatIve method for disposal ofthe 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 pape. r or cardboard except as provided under. Minneso.ta Statutes 17.135.
· To extinguish the fire immediately inhis permit is revoked." ,
. To have this permit available at tlie burn site for inspection.
. That prevailing wind must be away from nearby occupied buildings.
. That fires will not be allowed to smolder without flame.
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.
.
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PROHIBITED MATERIALS ARE: oils, rubber, p'lastics, tires and chemically' treated materials such as railroad ties
!reated .lumb~rl composite shingles, tar paper, insulation, composition board, sheet rock, wiring, paint, hazardous and
mdustrlal sol1o waste. I
VIOLATIONS OF PERMIT CONDITIONS MAY SUBJECT PERMITTEE TO CRIMINAL AND/OR CIVIL
ACTIONS.
REUSE, RECYCLE, AND COMPOST
1 attest, by my signature, that 1 have read and will comply with the conditions of, and any attachments to this permit; and that 1 am the
landowner or have permission of the landowner to burn at the above burn site location.
t-(rJ-o.:2-
Date Approving Authority Signature
t-ltJ-o ;L-
r
Date
Paid $25.00 permit fee 0 Check #
BURNPRMT
or 0 Cash
Revised 4-12-0 I