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Home My WebLink AboutBRN2010-00004 - BRN Permit - 1/25/2010 BURN PERMIT { Mason County Dept. of Community Development PO BOX 186 - 426 W Cedar St, Shelton WA 98584 - 360.427.9670 BRN201 0 =00004 If s /t 1 7 s 2 r• Issue Date Expiration Date Site Address: 300 E DALBY RD UNION 322325094008 32 22 3 6 Parcel Number Section Township Range Fire District Applicant: HOOD CANAL COMMUNICATIONS Address: 300 E DALBY ROAD UNION WA 98592 Contact Number(s) - Must be a 24 hour number Conditions: 1. Valid permit must be on-site while burning. 2. The following materials may 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 normally releases toxic emissions, dense smoke or obnoxious odors when burned. 3. All material must originate from the property on which the burning is to occur. 4. The fire must not create a nuisance from smoke, obscure visibility on public roads and highways or endanger life and property. 5. The maximum pile size is twenty (20) feet in diameter, with a minimum ten (10) feet firebreak around each pile. 6. Each pile must be at least one hundred (100) feet from any structure and at least fifty (50) feet from standing timber. 7. Do not burn if wind is blowing more than seven (7) MPH. 8. Do not burn if wind is blowing from direction. 9. The minimum people required to be in attendance at the fire while burning: 1 10. On site water required? 11. Provide excavator / dozer with a fire extinguisher at the site with a qualified operator. 12. Provide a 24-hour fire watch. 13. Fire must be completely extinguished within three (3) days after ignition. 14. Fan is required. 15. Other: Fire Warden: Signature Date -*YOU MUST CALL (360) 427-7761 EVERY MORNING TO REPORT IN** BRN2010-00004 01/22/2011 PERMIT NO 2c`T)_� MASON COUNTY BURN PERMIT APPLICATION 426 W. Cedar• P.O. Box 186, Shelton, WA 98584 Shelton (360) 427-9670 • Belfair (360) 275-4467 • Elma (360) 482-5269 •www.co.mason.wa.us APPLICANT INFORMATION CONTRACTOR INFO MATION Owner. ood Lakal Company Name a L £ �L C Mailing Address U Mailing Addre s Z City *t4 l tate 6( Zip Code City 1_56 — State e"- Zip Code Phone Ek- O her Ph.� 7oU0 Phone g42&-o00 3 Other Ph. 239 6764 Lien/Title Holder Contractor Reg. # ,C��x�.+�.[1 /r4 7 p. Q fu4Z A) E mail Address E Mail Address Drivers Lic. # DOB Drivers Lic. # 0 1/ DOB PARCEL NUMBER: 322 32s5 94008 Sec. Town. Rng. Fire District Site Address (Please include street name, number and city) Directions to site Z 12/9'.2wO 4& kc;.v w c w 04-1he joed Parcel within 200'eft ltwater❑ Lakep River/Creekp Pondp etland ❑Seasonal Runoffp Streamp Slopes or Bluffs 15% Is property flaggeXol''addressed prior to inspection s/No-Will timber be cut and sold in parcel preparation? Yes / o Reason for land clearing: yl/1 & /1oo�'�'► -�'� AKk &n* a&-t s�o�t. ,rtn �oo/s Is this site being converted or replanted? Yes / no Does site require FPA or 6 yr. Moratorium? YesAM) The person in charge of the fire may be liable for the cost of fire supression if the fire gets out of control or, if it becomes necessary to extinguish the fire as a result of enforcement action. Open burning shall be prohibited during any period of impaired air quality as designated by the Olympic Region Clean Air Agency,or during extreme fire danger due to dry weather conditions as designated by the Mason County Fire Marshal's Office. Information hotline(360)427-7799 Is this permit submittal the result of a Stop Work Notice,Correction Notice or other enforcement action? Yes/No Burning is authorized subject to the following conditions: Valid permit must be on site while burning. ,WThe 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 normally releases toxic emissions, dense smoke,or obnoxious odors when burned. II materials must originate from the property on which the burning is to occur. he fire must not create a nuisance from smoke,obscure visibility on public roads and highways,or endanger life and property. .ED-Maximum pile size is twenty(20)feet in diameter,a minimum ten(10)foot firebreak must be constructed around each pile. Each pile must be at least one hundred(100)feet from any structure, at least fifty(50)feet from standing timber. Do not burn if wind is blowing more than seven(7)miles per hour. JRf Do not burn if wind is blowing from 10 (direction) A responsible adult and equipment shall be required to be on site and in attendance at the fire while burning. On site water required: OYes Mo Provide X AVATOR/DOZER with a fire extinguisher)on site with qualified operator. Provide 24 hour fire watch. ire must be completely extinguished within three(3)days after ignition. an requiredAi!v %Other 'Upon completion of above conditions,applicant must call(360)427-9670 Ext.262 for inspection prior to burning OWNER/CONTRACTOR Acknowledges submission of inaccurate information may result in a stop work order or permit revocation. Acknowledgement of such is by signature below. I declare that I am the owner,owners legal representative,or the contractor. I further declare that I am entitled to receive this permit and to do the work as proposed in the application. I declare that I have obtained the permission from all the neces- sary parties. If permission is required from any easement holder or any other party in interest regarding this application or the work proposed in the application, I have obtained permission from them to apply for this permit and conduct the work proposed. The owner or agent on owners behalf, represents that the information provided is accurate and grants employees of Mason County access to the above described property for review and inspectio This permit/application becomes null and void if work is not completed within 30 days. Permit includes two (2) inspections ma)omum, addition i pections II equire a fee of sixty four(64)dollars per inspection. Date. Owner/Owners Representative/Contractor indicate which one FOR OFFICIAL USE BEYOND THIS POINT Accepted by: Date DEPARTMENTAL REVIEW APPROVED DENIED NOTES Fire Marshal FEES Burn Permit Fee Site Inspection Violation Fee State Fee Pre-Paid at Submittal Other EXPIRES: Date: Inspector TOTAL FEES 1/22/2010 Conditions Associated With 12:10:47PM Case #: BRN2010-00004 P10 Permit Condition Status Updated item# Code Title Status Changed By Tag Date 13' 1) 100 POST PERMIT NOT ME'T 1/22/2010 GMM Valid ermit must be on-site while burning. X 2) 150 PROHIBITED MATERIALS NOT MET 1/22/2010 GMM The following materials may 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 tha natural vegetation)that normally releases toxic emissions,dense smoke or obnoxious odors when burned. X 3) 200 ORIGINATION NOT MET 1/22/2010 GMM All mate ri originate from the property on whichthe burning is to occur. X 4) 250 NUISANCE NOT MET 1/22/2010 GMM The fire must npkcreate a nuisance from smoke,obscure visibility on public roads and highways or endanger life and prope X 5) 300 MAXIMUM SIZE NOT MET 1/22/2010 GMM The maximum pile size is twenty(20)feet in diameter,with a minimum ten(10)feet firebreak around each pile. X 6) 350 DISTANCE FROM STRUCTURES NOT MET 1/22/2010 GMM Each pile must be at least one hundred(100)feet from any structure and atleast fifty(50)feet from standing timber. X 7) 400 HIGH WIND NOT MET 1/22/2010 GMM Do not P m i wind is blowing more than seven(7)MPH. X 8) 450 WIND DIRECTION NOT MET 1/22/2010 GMM j Do not burn if wind is blowing from 10 INSPECTOR WILL COMPLETE ON INSPECTION CARD. X 9) 500 MINIMUM PEOPLE NOT MET 1/22/2010 GMM The mininjurn people required to be in attendance at the fire while burning: XX X 10) 550 ON-SITE WATER NOT MET 1/22/2010 GMM On site a gr required?XXX X 11) 650 24 HOUR FIRE WATCH NOT MET 1/22/2010 GMM Provid -hour fire watch. X 12 700 EXTINGUISH FIRE NOT MET 1/22/2010 GMM Fire m st b completely extinguished within three(3)days after ignition. X Page 1 of 2 CaseConditions..rpt 1/22/2010 Conditions Associated With 12:10:47PM IP14 Case#: BRN2010-00004 Permit Condition Status Updated item# Code Title Status Changed By Tag Date By 13) 750 FAN NOT ME 1 1/22/2010 GMM Fan rr fired. go X Page 2 of 2 CaseConditions..rpt