HomeMy WebLinkAboutBurn Permit 2005
PLEASE CALL SCOTT COUNTY DISPATCH AT 952-445-1412 THE DAY YOU ARE GOING TO BURN.
CALL 651.772.7930 NO MORE THAN 1 HOUR PRIOR TO BURNING
Permit #..55
~II or aMail
PERMITTEE INFORMATION
BURNING PERM IT FOR SCu I I COUNTY
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Name W-illlo(YI C<:;l\~
Ad dress )t:) 341- WI W TVf k.1II ~ +
,
Oty ?vl'af LAu State1lliQZip 55312-
Phone# Cfsz. LJ40.508~
BURN SITE LOCATION
Township
Address
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EFFECTIVE DATES From: M .') ID 2.'5 IY ()~
DAILY HOURS From: --3-AM/~
BURNING PERMIT CONDITIONS (Check those that apply)
CJ PILED MATERIAL (Cean Wood)
(~ecify)
# Piles Approx. Pile Sze
jJ( RUNNING FIRE ((?casslan d)
Sze,of Area in Acres_J.iJJo #Ian tt.~a(yf'...
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[J SPEOAL CONDlTIONSM-dcM.-n € ~Itl Lik 10 hurt-I"
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To: MOw ID 30 IY (OOS
To: . SAM8 OR [J ALL DAY
This perm it is valid for opan burning as allowed and specified in Minn. FaI/es 7005.0705 to 7005.0805, MSJ16. Minn. Uniform Are
code, and local ordinances. The permittee is granted permission to burn the above described materials at the specified location
during the dates and times/is/ed above.
FIRE ~FETV AND AIR QUALITY REQUIREMENTS
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. To keep thisfire under control and to assume responsibility for all damages and costs that may result from
burning done under this permit.
. To attend thisfire until completely extinguished.
. Not to burn if there is a practical alternative method for disposal of the material such aschipping 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 asprovided under Minnesota Satutes 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 MA II=r<IALSARE: 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 CONDlllONS MAY SUBJECT PERM I I I t:t: TO CRIMINAL AND/OR OVlL ACTIONS
RBJSE, ru:Lfa.E, AND OOMPOST
I attest, by my signature, that I have read and wifl comply with the conditions of, a~~t..ny attachments to this
permit; and that I am the landowner or have permission of the landowner to burn i the above bum site location.
.......- J ~ / ;/
~~~ 5J.)J/q(- ~/W/f-<.A "/7-/"'~
Per jttee' s Sgnature Date Approving Aurhoifty ~nat;e -~ 'I Date -
Paid $25.00 permit fee ~OleCk #t: D\
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or
Q Cash
Mail form back to:
City of Prior Lake-Bum Permit
16200 Eagle Creek Ave SE
Prior Lake. MN 55372