HomeMy WebLinkAboutBRN0055 - BRN Permit - 10/7/2002 77-1
OFFICE OF THE MASON COUNTY FIRE MARSHAL ., 0
LAND CLEARING BURN PERMIT '�55
Office Use: Validation Date C7 O f Piration Date
THIS PERMIT IS VALID v egsusPended_
LIB F R 30 DAYS FR
To.not' before ignition: M THE DATE F I UE.
Sec. Fire Dist.site: T R (E) Directions - Phone
�7 Q • mileage (ad ress if applicable) to bum THE PERSC� Grl-e" '� Z2 (32 k k - k)
N IN CHARGE OF THE FIRE 9O 2 6� '�
IF THE FIRE GETS OUT OF CONTROL OR IF IT LIABLE
cs�
MAY BE LIABLE FOR THE COST OF SUPPRESSION
THE FIRE AS THE RESULT OF AN ENFORCEMENT ACTT
BECOMES NECESSARY TO EXTINGUISH
OPEN BURNING SHALL gE PROHIBITED DURING ANY p ON.
AS DESIGNATED BY THE PROHIBITED
AIR POLLUTION CONTROL
AN EXTREME FIRE DANGER DUE TO DRY LLU TO ERIOD OF IMPAIRED AIR QUALITY
ER ONDAL. qS D S GN OR DURING
THE MASON COUNTY FIRE MARSHAL,
ATED BY
BURNING IS AUTHORIZED SUEUECT TO THE FOLLOW
1• Valid permit must be on site while burning. FOLLOWING CONDITIONS:
2 PROHIBITED MATERIALS.
Garbage, dead animals The following materials May
Paper, cardboard, • asphalt, petroleum Y not be burned:
treated wood, Aroducts, paints, rubber
(other than natural vegetation) construction/demolition debris Products, plastics,
obnoxious odors getation) that normally releases to emissions, de
when burned. • metal, or any substance
3 Materials to be burned shall not be dense smoke, or
originate from the props moved from one site to another.
4. The fire must not create a nuisance which
homing is to occur. All material
highways, must
ys• or endanger life and smoke, obscure visibility
5 Maximum pile size is twentyproperty' ity on Public roads and
0) feet in diameter.
s• A minimum 10-foot'firebreak must be constructed
7• Each pile must be at least 100 feet from any around each pile,
8• Do not burn if Y structure, at least 50 feet from standing
9• Do not burn if wind is from ing more than,�.rinph
10.Minimum people required to be �n �`— (Direction)
11•Water requirement: attendance at the fire while burning-
EXCAVATOR
Provide an: in
HOSE.LIN
operator. EXCAVATOR PUMP TRUCK/TRAI'
13.Provide 24-hour fire watch. DOZE at the site, with a
14.Fire must be completelyES qualified
15. Other conditions: extinguis NO.
within three (3) days after ignition.
�(Fee Amoun � PERMIT FEE INFORMATI
3 t
Check No. —Received By
tta h ch ck Est. Tonnage_��],�
Issued by '"" a ble n Coun Tr a urer.
ire n, Si tore na Date
9 C � �
BY signing this Permit, .•1 agree to comply Smoke Management Plan in effect at the with
all requirements of Chapter 332-24 W
this permit. of burning and any additional terms and
C, the
Landowner AIA
�' a ,vsa,v
Home Phone �c ., „� .,�.
_ r A
Landowner/Agent �'A Work Phone
11
Home Phone
Mailing Address C'` :� Work Phone `4 c^
Signature of Landowner/Agent
ORIGINAL-Landowner Canary-Fire Marshal pi
nk_Fire Warden . Goldenrod-Fire District -