• Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Muswellbrook Shire Council ABN 86 864 180 944
    Ph 02 6549 3700 • Fax 02 6549 3701 • Email
    PO Box 122 Muswellbrook NSW 2333 • 157 Maitland Street, Muswellbrook

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  • Approval to burn application
    Made under Clause 13 of the Protection of the Environment Operations (Clean Air) Regulation 2010
    Muswellbrook Shire Council is listed in Part 2 and 3 of Schedule 8.

  • Advice: Obtain all necessary approvals from the NSW Rural Fire Service or the NSW Fire Brigade regarding planned burns.

Person requesting approval

  • Name

  • Add location
  • Phone numbers

  • Fax, email address to return assessed application.

Burn details

  • Photographs of pile.

  • Purpose

  • Approval to burn is not required.

  • Council may not approve the burning of such article for the purpose stated.

  • Vegetation from the property?

  • Vegetation is dry?

  • No other rubbish materials?

  • The pile does not include tyres, paint or solvent containers/residue, coated wire, treated timber and or vegetation.


  • Approval is granted.

  • From

  • To

  • Approved by (Signature).

Conditions of Approval

  • 1. Twenty four hours prior notice must be provided to owners/ occupiers of adjoining land, including land that is separated by a lane, road or waterway. The notice must specify location, purpose and time frame of the fire.
    2. Extinguishing the fire should wind conditions result in the transport of smoke directly impacting neighbouring properties and residences.
    3. You must ensure that you have sufficient water supply and/or fire extinguishers to extinguish the fire.
    4. All works should be in accordance with the Rural Fire Service Guidelines for Pile Burning
    5. This permit must be retained on-site for inspection by any authorised person while the fire is in progress or used and maintained in accordance with the conditions of the permit.
    6. In the event of a total fire ban being declared this permit is suspended for the entire period of the ban. Any existing fire must be immediately extinguished.
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    7. In the event of a No Burn Day being declared, this permit is suspended for the duration of the declaration.
    8. A fire may only be lit on land where it is consistent with any Bush Fire Risk Management Plan applying to the land.
    9. This permit is subject to variation, suspension or revocation by the appropriate authority, verbally or in writing
    10. Council is to be notified in writing of the completion of the works subject to this approval, including details of any complaints received during the period of the approval.

  • Additional conditions:

  • Approval not granted (signature).

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