Information
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Burn address
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Date and time issued?
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Document No.
Contact Information
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Contact Name:
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24/7 Emergency Contact Phone Number:
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Company Name & address: (if applicable)
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Office Phone Number:
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DNR permit # if required.
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CAD #
Burn Information
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Type of Burning
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REGULATIONS:
1. Only trees, brush, and limbs shall be burned. NO burning of materials for waste disposal is allowed. There shall be no burning of leaves, except for those still attached to the branches.
2. Fire area shall be no closer than 50' from a structure.
Exceptions: Large brush piles shall be at least 200 yards from any structure.
Fires in approved containers shall Benz closer than 15' from structure.
3. Fire shall be constantly attended until it is extinguished.
4. Fire extinguishment equipment shall be available for immediate utilization at all times during the open burning operation.
5. Fire shall be extinguished by dusk.
Exception: Large brush piles that cannot be burned in a single daylight period.
Burning past dusk must be approved by the fire official.
6. Permit is valid only for the date of issuance.
7. This permit does not relieve the permit holder from compliance with state or federal regulations.
NOTICE: The fire official shall have the right to revoke this permit for any violation of the above regulations, or if the open burning creates or adds a hazardous or objectionable situation.
area
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Location?
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Special Instructions
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Approved for 24 hour burning?
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Extinguishing equipment on site?
- Garden Hose
- Hand tools
- Fire extinguisher
- earth moving equipment
- other
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What?
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Site Inspection Approval
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Permit issued to:
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Fire Inspector:
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Comments:
