HomeMy WebLinkAboutBRN2022-00086 - BRN Permit - 11/8/2022 (2) EXPIRATION DATE: Permit#: BRN joll-
MASON COUNTY BURN PERMIT APPLICATION
615 W Alder St• Shelton WA 98584
APPLIC T/OWNER INF I�MATION: CONTRACTOR INFORMATION:
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Owner V'V, Owner s k
Mailing Address Mailing Address
City U State Zip C( City. State Zip
Phone• c� W ell Phone Phone Other Phone
Lien/Title Holder Contractor Reg.#
E-mail addressl ,Cv Ql'^) U o0 -- Qi1 1- E-mail address
Drivers Lie.# D.O.B. - 1 cam, Drivers Lie.# D.O.B.
TAX PARCEL NUMBER'-2-)a ,(�, c� - G C C (�'� (12 digit number) Fire District
SITE ADDRESS(please include street name,number&city)
Directions(to the site)Aq 'Q 'Sar Vg�- - Lt; A C`�
BURNING IS AUTHORIZED SUBJECT TO THE FOLLOWING CONDITIONS:
• Valid permit MUST be onsite while burning.If permit is not on site during burning the fire will be extinguished at your cost.
• The following materials are prohibited and must not be burned: garbage, dead animals, asphalt,petroleum products,paints, rubber
products, plastics, paper, cardboard, treated wood, construction/demolition debris, metal or any substance (other than natural
vegetation)that releases toxic emissions,dense smoke,or obnoxious odors.when burned.
• All materials must originate from the property on which the burning is to occur.
• The fire must not create a nuisance from smoke,obscure visibility on public roads and highways,or endanger life and property.
• Maximum pile size is twenty(20)feet in diameter,a minimum ten(10)feet firebreak must be constructed around each pile.
• Each pile must be at least one hundred(100)feet from any structure and at lease fifty(50)feet from standing timber.
• Do not bum if wind is blowing more than seven(7)miles per hour.DO NOT BURN IF WIND BLOWING FROM
• A responsible adult and equipment shall be on site and in attendance at the fire while burning.Must provide 24 hour fire watch.
• On Site Water is required for permits between April 15'h and Oct. 15`h.A pump truck or trailer with 300 gallons of water loaded and
200 ft of hose.(The pump must be capable of pumping 20 gallons per minute through a one inch(diameter)50 foot section of hose.)
• Provide EXCAVATOR/DOZER(with fire extinguisher)on site with qualified operator.
• Fire must be completely extinguished within three(3)days after ignition.
• Fan required.
•. Upon completion of above conditions,applicant must have inspection&approval before ignition.Call (360)427-9670,ext.262
• APPLICANT'S MUST CALL 360.426.4441 EACH DAY TO REPORT BURNING ACTIVITY.
• APPLICANTS MUST CALL 360.539.7610(ORCCA) EACH DAY TO REPORT/REQUEST ANY AIR QUALITY ISSUES
ASSOCIATED WITH BURNING.
************IF BURNING WITHOUT CALLING IN,THE FIRE VVML BE EXTINGUISHED AT OWNERS EXPENSE
AND POSSIBLE SUSPENTION OF PERMIT.***************
• After the burn is complete make sure the fire has not burned into the earth by checking the fire location for hot spots.
• It is advisable to pump the entire content of the water tank onto the burn site to assure the fire is completely extinguished_ The
permitted individual is responsible for any rekindling'on the fire/bum site.
• A BURN BAN when implemented by Fire Marshal will take effect as noted and all permits become null and void.After a bum ban
has been implemented, all fires must be extinguished immediately.
• Permit includes two(2)inspections maximum,additional inspections will require a re-inspection fee.(at current rate)
• Access must be passable with 2 wheel drive vehicle
Date Received:
Application continued, please go to next page b
Rev.Aar 19.20i7