HomeMy WebLinkAboutBurn Permit 2006
PLEASE CALL SCOTT COUNTY DISPATCH AT952-445~1412THEDA Y YOU ARE GOING TO BURN.
Permit # tK
CALL 651-772-7930 NO MORE THAN 1 HOUR PRIOR TO BURNING
IERMITTEE INFORMATION
BURNING PERMIT FOR SCOTT COUNTY
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BURNING PERMIT CONDITI~S (Check those that apply)
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[J PILED MATERIAL (Oean W. ood) /
(Specify) ~,.e~s A -Ir /3~~es
# Piles I ~pprox. Pile Size /0
tr(CaIl or oMail
Name hl'fllt..> !--le~ (!lu,.t.tk..
Address /dJ ca 'II) Jlwu /:3
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aty State Zip
Phone #_ t-/L/? 4:> Cf~5
[J RUNNING FIRE (Grasslan d)
Size of Area in Acres
BURN SITE LOCATION
Township
[J SPEOAL CONDITIONS
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EFFECTIVE DATES: From: Ml'\ IDI'-'1 IY(!)/J
DAILY HOURS: From:.~ AM~
To: M~D..L:l-IY~
To: ~PM OR [J ALL DAY
This permit is valid for open burning as a/lowed and specified in Minn. RJ/es 7005.0705 to 700f .0805, MS f 16, Minn. Uniform Fire
code, and /oca/ordinances. The permittee is granted permission to burn the above describea materia/sat the specified location
-luring the dates and Um 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 thisfire until completely extinguished.
· Not to burn if there isa practical alternative method for disposal of the ma1erial 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 asprovided under Minnesota Statutes 17.135.
. To extinguish the fire immediately if thispermit isrevoked.
. To have this perm it 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, p last ics, tires and chem ically treat ed materials such as railroad
ties, treated lumber, composite shingles, tar paper, insulation, compositioll board, sheet rock, wiring,
paint, hazardous and industrial solid waste.
VIOLATIONS OF PERMIT CONDITIONS MAY SUBJECT PERMITTEE TO CRIMINAL ANC/OR aVIL ACTIONS.
REUSE, RECYQ.E, AND COMPOST
FIRE SAFETY AND AIR QUAUTY REQUIREMENTS
I attest, by my signature, that I have read and will comply with the conditions of, alld any attachments to this
permit; and that I am the landowner or have permission of the landowner to burn r the above burn site location.
0?/L~#~ .. 5'//'7/0tb -1b~ - J! .)':fi""t'~
'HR1'fttee'sSgnature '/' ,F Date Approving Authority Sgnatllre (-;bate
Paid $25.00 perm it fee 0 Oleck # '?5"64 or 0 Cash
;'vft k e.. a ~(p 55
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Mail fl )rm back to:
City of Prior Lake-Burn Permit
16200 Eagle Creek Ave SE
Prior Lake, MN 55372