HomeMy WebLinkAboutBurn PErmit 2006
PLEASE CALL SCOTT COUNTY DISPATCH AT 952-445~1412THE DAY YOU ARE GOING TO BURN.
Perm it #
5:?
CALL 651-772-7930 NO MORE THAN 1 HOUR PRIOR TO BURNING
BURNING PERMIT FOR SCOTT COUNTY
~II or QMail
'ERMITTEE INFORMATION
BURNING PERMIT CONDITIO't'lS (Check those t hat apply)
NameMa.1"'k. (Y\a~th~~. CJ
Address J~';)..JD J-kJaDyd Lr"QO
aty~e::.JI Stat e!tln Zip ~S) 79
Phone # <I~a... ,-~ ,~-~~g-Co
PILED MA~~an "!I. ood) S 1
(Specify) .. n.~,4 '\~t'\oo~
# Piles ' Approx. Pile Size /t7Y/O
CJ RUNNING FIRE (Grasslan c1) ~ ,......
Size of Area in Acres "'ll'r
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BURN SITE LOCATION
o SPEOAL CONDITIONS
Township ~,+A-""<...
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City
EFFECTIVE DATES: From: M_h ID ~ 1Y(9'f/
DAILY HOURS: From: ~ ~
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To: M J ID 'J. IYUl ~
To: Y' A~ ~R 0 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 describeq materials at the specified location
~uring the dates and tim es listed above.
I AGREE:
. To keep thisfire under control and to assume responsibility for all damageS! and costs that may result from
burning done under this perm it.
. To attend this fire until completely extinguished.
. Not to burn if there isa practical alternative method for disposal of the material such aschipping or
com posting,
. 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 Statu~es 17.135.
. To extinguish the fire immediately if this permit isrevoked.
. 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, plast ics, tires and chem ically trea~ed materials such as railroad
ties, treated lumber, composite shingles, tar paper, insulation, compositioln board, sheet rock, wiring,
paint, hazardous and industrial solid waste. '
VIOLATIONS OF PERMIT CONDITIONS MAY SUBJECT PERMITTEE TO CRIMINAL ANIpIOR aVIL ACTIONS.
REUSE, REcya...E, AND OOMPOsr
FIRE SAFETY AND AIR QUALITY REQUIREM!=NTS
I attest, by my signature, that I have read and will comply with the conditions of, ~nd any attachments to this
permit; and that I am the landowner or have permission of the landowner to burn lat the above burn site location.
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'ermittee'sSignature
Date
App7O'ving Aut hority Sig n at ure
Date
Paid $25.00 perm it fee 0 O1eck #
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Mail form back to:
City of Prior Lake-Burn Permit
16200 Eagle Creek Ave SE
Prior Lake, MN 55372