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BURNING PERMIT FOR SCOTT COUNTY
MAY 1 2 \998
PERlhu lEE INFORMATION
BURNING PERMIT CONDITIONS (C'e'flYtofePIi\t~~)<E
Name VI~ (.plt-~> Gov:- Cwg
Address 3/~ I UIL.P~ /ZIPk..
City ~ 1{7t2. tA-~ State.M,--J Zip 55371-
Telephone Number 49", -0037
o PILED MATERIAL (Clean Wood)
(Specify) -r~-s
# Piles r Approx_ Pile Size go' c-lk",,",_
o RUNNING FIRE (Grassland)
Size of Area in Acres
BURN SITE LOCATION
Address
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(i ~PECIAL CONDITIONS .D.. _ I '. ......J. ..)
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EFFECTIVE DATES: From: M :/ /D1.~fY
DAILY HOURS: From:?' ~
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This permit is valid for open burning as aI/owed and specified in Min11. Rules 7005.0705 to 7005.0805, MS f.16, Min11. 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 bum 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 bum paper or cardboard except as provided under Minnesota Statutes 17.135.
· To extinguisb the fire immediately if this permit is revoked.
· To have this permit available at the bum SIte for inspection.
· That prevailing win.d must be away from nearby occupied buildings.
· That fires will not be allowed to smolder without flame.
PROIDBITED MATERIALS ARE: oils, rubber, v.lastics, 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 solia waste.
VIOLATIONS OF PERMIT CONDITIONS MAY SUBJECT PERM111bE TO CRIMINAL AND/OR CIVIL
ACTIONS.
REUSE, RECYCLE, AND COMPOST
1 attest, by my signature, that 1 have read and will comply with the COndit"r}-011S and any att;;gChments to his permit; and that I am the
landowner or have permission of the landowner to burn at the above burn s' e cation.
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BURNPRMr.DOC
Revised 7/31/97