HomeMy WebLinkAboutBurn Permi t - 7/02
CALL 651-772-7930 NO MORE THAN 1 HOUR
PRIOR TO BURNING
i
l
perfit # iLL
!(}Call or ClMail
BURNING PERMIT FOR SCOTT COUNTY
PERMITTEE INFORMATION
Name BJt,f,--l ~t^(~ S
Address /5"3'r,fo P'ieec! P f . M Sf:
City Jf;CI'" 4te- StatllN Zip~mz.
TelephoneNumberCr~2) 440. 2S-g I
BURNING PERMIT CONDITIONS (Check those that apply)
!)-PILED MATERIAL (Clean Wood)
(Specify) "lV(!iotf! J hrf,(.~Al <;:f Ic:../::.s... ,
# Piles Approx. Pile Size
8~~ vtU-{I.-....A {oTb~ ~ ~-ltu<-O,
CJ RUNNING FrKE (Grassland) 0
Size of Area in Acres
BURN SITE LOCATION
SPECIAL CONDITIONS
;
Township 5tJ 1M. e C(..$ ~ PO ve..
r (f br f\ () ~ 1 r:p-e.. /l-f f:>~
9V'\
Address
b~l-r~ -
.p..= ,
~L-L
--1""1 fV"'-<::'-
City
EFFECTIVE DATES:
DAILY HOURS:
/Dl..L-N~
A~ OR [J ALLDAY
This permit is valid/or 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 arzd times listed above.
:TP, "\]t
f::-{"i~t~>>l
:. "'" !fh-~HP'- ~r~A' ~H (f{!I~j~~J)~,jlWf,,'i}17;~UCf;jJJy~~n .H;~J;':i~~ltijl1}(:!9'(i)~'~\\ "'~,(oH: \'JI~.p' ti'm~(~ i.L:~)l)H(~ ~~
FIRE SAFETY AND AIR QUALITY REQUIREMENTS
I AGREE: '
. ' To k~ep this fire unde~contro'J and to assume responsibility for all damages and costs that may result from
burnmg done under thiS permJt. . .
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 paller or cardboaro except as provided under Minnesota Statutes 17.135.
. To extinguisn the fire immediately if this 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.
.
.
.
.
PROHIBITED MATERIALS ARE: oils, rubber, p'lastics, tires and chemically. treated materials such as railroad ties
!reated .Iumb~rl composite shingles, tar paper, insulation, composition board, sheet rock, wiring, paint, hazardous and
mdustrlal solta waste.
I
VIOLATIONS OF PERMIT CONDITIONS MAY SUBJECT PERMItTEE 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. have permission of the landowner to burn at the above burn site location.
1/11/ tJ7-
Date
crz..--
7 / (( /t:fL
Dme (
Paid $25.00 permit fee lJJ..Check # ? IJ- ~ or 0 Cash
.
BURNPRMT
Revised 4-12-0 I