HomeMy WebLinkAboutBurn Permit 2007
PLEASE CALL SCOTT COUNTY DISPATCH AT 952-445-1412 THE DAY YOU ARE COINC TO BURN.
permit #2!1
Deall or DMail
BURNING PERMIT FOR SCOTT COUNTY
ERMITTEE INFORMATION
BURNINC PERMIT CONDITIONS (Check those that apply)
Name btrc4 ) 0 }{J1. fG ~ m A-,v rJ
Address Y 9 3.3 6J fl./( 5 r
Cityfr.'v.- L..1l1"c:.'state II11"Zip s:r371-
Phone # q )"l- - t{4. 1 - d.} l' --\"
~ PILED MATERIAL (Clean Wood)
(Specify)
I # Piles Approx. Pile Size / u y ( D
o RUNNING FIRE (Grassland)
Size of Area in Acres
BURN SITE LOCATION
o SPECIAL CONDITIONS
Township
Address
City
'-193 () t?J4I<; 51"
~-d
To Be Completed
By Fire Dept.
EFFECTIVE DATES: From: M~/D---..5-1Y 0
DAILY HOURS: From: AM/PM To:
To: M
AM/PM
This permit is valid for 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 and times listed above.
FIRE SAFETY AND AIR QUALITY REQUIREMENTS
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 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 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.
PROHIBITED MATERIALS ARE: oils, rubber, plastics, tires and chemically 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 CIVIL ACTIONS.
REUSE, RECYCLE, AND COMPOST
I attest, by my signature, that I have read and will comply with the co ditions of, and any attachments to this
permit; and that I am the landowner or have permission of the land ner to burn at the above burn site location.
Paid $25.00 permit fee 0 CheCk #
or
/(;1;-</,-cP7
Date
ICJ /~/07
Date
Mail form back to:
City of Prior Lake-Burn Permit
4646 Dakota St SE
Prior Lake, MN 55372