HomeMy WebLinkAboutBurn Permit 2006
+ PLEASE CALL SCOTT COUNTY DISPATCH A T952;.445~1412 THE DAY' YOU ARE GOING TO BURN.
CALL651-772-7930 NO MORE THAN 1 tiOURP~OR to BURNING
Permit #-0
~II or oMail
BURNING PERMIT FOR SCOTT COUNTY
ERMITTEE INFORMATION
Name eJ wa..:,...J GJ-< 91::) A- y
,
Address 5tt; D - / r~ t/' f(
aty,Pr.~i't'l l-~lt'e:state /'1ttZip fj~:>1 0<_
Phoner t./~ -7Y9 - ? 1 ~
ef!''f)~ 'V VY5 - ~ / ;v ;/
BURN SITELOCATION
Township
Add ress
s cz- 4?;O
Oty
EFFECTIVEDATES: From: M-1.LJ~. N Oc,
DAILY HOURS: Fro m : _ _7 (1tMJ.-
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BURNING PERMIT CONDITIONS (Check those that apply)
CJ PILED MAT~(a~an l~ood)
(~ecify) ./V~ f'?~
# Piles f::t) Approx. Pile Size / O"X /6
Cl RUNNING FIRE (Grasslan d)
Size of Area in Acres
Cl SPEaAL CONDITIONS
~,-, .. /..~,,..-
/1/ / 0 (1/ A:-
i II" ~
.30 ~/
V -
~ fJW fio 1D/8J;i;)
TO:fV1~.'~~ N<1f.4
To:_ -~ (.pM OR
CJ ALL DAY
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771 is 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. 771e perm ittee is granted perm ission to burn the above described materials at the specified location
--1uring the dates and times fisted above.
FIRE SAFETY AND AIR QUAUTY REQUIREM ENTS
IAGREE:
. To keep thisfire under control and to assume responsibility for all damages and coststhat may resu1t from
burning done under this perm it.
. To attend thisfire 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 paper or cardboard except as provided under Minnesota Sat utes 17.135.
. To extinguish the fire immediately if this permit is revoked.
. . To have l.!W>..perm it available at th.e burn site.io.rinspe~.<~.-- '"
. --'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 chem ically treated materials such as railroad
ties, treated lumber, composite shingles, tar paper, insulation, composition board, sheet rock, wiring,
paint, hazardous and industrial solid waste.
VIOLATIONS OF PERMIT CONDITIONS MAY SUBJECT PERMITTEE TO CRIMINAL AND/OROVlL ACTIONS.
REUSE, RECYCLE, AND OOMPOsr
r<
~
a attachmentsto this
e ab i/7/~Z;
4~~J
--
I attest, by my signature, that I have read and wiff comply with the
permit; and that I am the landowner or have permission of and
y
-~"1
Mail form back to:
City of Prior Lake-Burn Permit
16200 Eagle Creek Ave SE
Prior Lake, MN 55372
Paid $25.00 perm it fee lJt6,eck #.J.?:- (/D. or 0 Cash
..J JSr~"
~. .--------.--------.-. --. .- _.--
PLEASE CALLSvuII COUNTY DISPATCH AT 952445-1412 THE DAY YOU ARE GOING TO BURN.
Permit #M
CALL651-772~7930 NO MORE THAN 1 HOUR PRIOR TO BURNING
~II or oMail
BURNING PERMIT FOR SCOTT COUNTY
ERMITTEE INFORMATION
BURNING PERMIT CONDITiONs (Check those that apply)
!
Name CJ W (L..'1---J Gt-< 91:) ;., Y
/
Address 5tp/CJ - /'Y~ rvJ'1f
at Y PH D"Yl L- ~/~es. at e /'1 ttZi P .p->").1 0<. _
Phoner /;./!) --/y9 - ~ 7 ~
I!!If ~ ff- 'V <7 Y 5 - 5" / .>-- ;;I
BURN SITELOCATION
Cl PILED MAT~(aean .~ood)
(Specify) ~ ~~
# Piles 1/1') ~pprox. Pile Size I \OJ( /6
~
Cl RUNNING FIRE (Grasslan dl)
Size of Area in Acres
Cl SPEOAL CONDITIONS
Township
Address
S rr 4--j jO
_ t ~
111/ (') tV.c-
( v
aty
EFFECTIVE DATES Fro m: M-LLJD_ tA3/Y Oa,
DAILY HOURS From: h AM(t'M)
--
( E.\lT&t1 OW to ~~~ 4kv O~ rlW.S1 cctLL ~u~3
1O:M~.4DYOC4 . ~ W"l~
To :-1ll.c~IV}/PM OR Cl ALL DAY -
This perm it is valid for open burning as allowed and specified in Minn. Rules 7005.0705 to 700$.0805, MS f 16, Minn. Uniform Fire
code, and local ordinances. The perm ittee is granted perm ission to burn the above described materials at the specified location
'furing the dates and times listed above.
FIRE SAFETY AND AIR QUAUTY REQUIREMENTS
IAGREE:
. To keep thisfire under control and to assume responsibility for all damages and coststhat may result from
burning done under this perm it.
. 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 paper or cardboard except as provided under Minnesota 9atutes 17.135.
. To ext inguish t he fire im m ed iately if t his perm it is revoked.
. To have this permit available at the burn site for inspection.
. That prevailing wind must be away from nearby occupied buildings.
. That fireswill not be allowed to smolder without flame.
PROHIBITED MATERIALS ARE: oils, rubber, plastics, tires and chem ically treated materials such as railroad
ties, treated lumber, composite shingles, tar paper, insulation, composition board, sheet rock, wiring,
paint, hazardous and industrial solid waste.
VIOLATIONS OF PERMIT CONDITIONS MAY SUBJECT PERMITTEE TO CRIMINAL AND/OR OVlLACTIONS.
REUSE, RECYQ.E, 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 the above burn site location.
-
~ h? ~Ml~ ....~~ ~-.)I~~: -
'ermittee'sSignature / -~U.vv;)" , Date Approvin
")
~/:21~
Paid $25.00 perm it fee !Jt6,eck #,;.}'; t'D. or 0 Cash
..J asrJ.-V
Mail form back to:
City of Prior Lake-Burn Permit
16200 Eagle Creek Ave SE
Prior Lake, MN 55372