HomeMy WebLinkAboutBurn Permit - 11/02
BURNING PERMIT FOR StftYrt tOUNTY
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CALL 651-772-7930 NO MORE THAN 1 HOUR
PRIOR TO BURNING
PERMITTEE INFORMATION
BURNING PERMIT CONDITIONS (Check those that apply)
Name (}0~ SC~ ("->ft..k
Address fo~ U:::, (~J) 51)G W
City GlP-l c{( LA 'rk Statem~ zip'S')37J-.-
Telephone Number '1)d,,..L{LID- Y l} ~
ri PILED MATERIAL (Clean Wood)
(Specify) fJRAJr~ 6Jl/!JJ'rI- OOJ:> T./2/Lf
# Piles I Approx. Pile Size J 0 )( /l>
o RUNNING FIRE (Grassland)
Size of Area in Acres
,
BURN SITE LOCATION
City
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o SPECIAL CONDITIONS
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Township
Address
,
EFFECTIVE DATES:
DAILY HOURS:
To:
IV 0.;2
OR 0 ALLDAY
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 to burn the above described materials at the specified location
during the dates and times list~d above.
,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 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.
FIRE SAFETY AND AIR QUALITY REQUIREMENTS
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PROHffiITED MATERIALS ARE: oils, rubber, p'lastics, tires and chemically' treated materials such as railroad ties
treated .lumbc::rl composite shingles, tar paper, insulation, composition board, sheet rock, wiring, paint, hazardous and
mdustrial soh a waste. .
~ VIOLATIONS OF PERMIT CONDITIONS MAY SUBJECT PERMmEE 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 perm is ion of the landowner to burn at the above burn site location.
Date
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J(, /5 -0;;),
. Date
//- /"J ~';?J:J
Paid $25.00 permit fee ~eck # J f 15'3 or
o Cash
BURNPRMT
Revised 4-12-0 I