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Home My WebLink AboutBRN2009-00052 - BRN Permit - 12/11/2009 BURN PERMIT Mason County Dept. of Community Development PO BOX 186 - 426 W Cedar St, Shelton WA 98584 - 360.427.9670 BRN2009 =00052 #7 IssA Date Expiration Date Site Address: 8830 E STATE ROUTE 106 UNION 322353200070 35 22 3 6 Parcel Number Section Township Range Fire District Applicant: MIKE OBLIZALO Address: P O BOX 451 UNION WA 98592 PH1 : 1.360.490.5475 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: LbK12VA/001P Signature Date **YOU MUST CALL (360) 427-7761 EVERY MORNING TO REPORT IN** BRN2009-00052 12/10/2001 12/10/2009 iConditions Associated With 10:32:34AM Case#: BRN2009-00052 Permit on ition Status Update item#! Code Title Status Changed By Tag Date By 1) 100 POST PERMIT NOT MET 12/10/2009 GMM Valid permit must be on-site while burning. X M-0 2) 150 PROHIBITED MATERIALS NOT MET 12/10/2009 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 than natural vegetation)that normally releases toxic emissions,dense smoke or obnoxious odors when burned. X 3) 200 ORIGINATION NOT MET 12/10/2009 GMM All material must originate from the property on whichthe burning is to occur. X YW 4) 250 NUISANCE NOT MET 12/10/2009 GMM The fire must not create a nuisance from smoke,obscure visibility on public roads and highways or endanger life and property. X ,n'V 5) 300 MAXIMUM SIZE NOT MET 12/10/2009 GMM The maximum pile size is twenty(20)feet in diameter,with a minimum ten(10)feet firebreak around each pile. ILA-)X 6) 350 DISTANCE FROM STRUCTURES NOT MET 12/10/2009 GMM Each pile must be at least one hundred(100)feet from any structure and atleast fifty(50)feet from standing timber. X kt�) 7) 400 HIGH WIND NOT MET 12/10/2009 GMM Do not burn if wind is blowing more than seven(7)MPH. X nAo 8) 500 MINIMUM PEOPLE NOT MET 12/10/2009 GMM The minimum people required to be in attendance at the fire while burning: XX X rk-o 9) 600 EXCAVATOR/DOZER NOT MET 12/10/2009 GMM Provide excavator/dozer with a fire extinguisher at the site with a qualified operator. X 10) 650 24 HOUR FIRE WATCH NOT MET 12/10/2009 GMM Provide a 24-hour fire watch. X /"-i 11) 700 EXTINGUISH FIRE NOT MET 12/10/2009 GMM Fire must be completely extinguished within three(3)days after ignition. X l� 12) 750 FAN NOT MET 12/10/2009 GMM Fan is required. X 11AJ Page I of 1 CaseConditions..rpt PERMIT NO. 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 APPLICAN I,NFORMATI CONTRACTOR INFQMMATION / Owner C� 1 �� 1 Company Name V C�/1�L �X� Mailing,Address Mailing Address City ate Zip Code City State Zip Code Phone 3LL Nther Ph. ? Phone Other Ph. Lien/Title Holder Contractor Reg. # Exp. E mail Address E Mail Address Drivers Lic. # DOB Drivers Lic. # DOB PARCEL NUMBER: — -- Town. Rng. Fire District Site Address(Please i I de street name, number and city) _ �� Directions to site (Y 55 , -> Z ,n t ) b Parcel within 200'of Saltwaterp Lake❑ River/C reeta Pondp Wetland p Seasonal Runoffp Streamp Slopes or Bluffs> 15% Is property flagged or addressed prior to inspectio es No-Will timber be cut and sold in parcel preparation? Yes (_No Reason for land clearing: Lvi Is this site being converted or replanted? Yes / `No Does site require FPA or 6 yr. Moratorium? Yes .No., 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: 13 Valid permit must be on site while burning. 13 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 normally releases toxic emissions, dense smoke,or obnoxious odors when burned. 0 All materials must originate from the property on which the burning is to occur. 0 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)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. Do not burn if wind is blowing from (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: [3 Yes [3 No Provide EXCAVATOR/DOZER(with a fire extinguisher)on site with qualified operator. Provide 24 hour fire watch. 13 Fire must be completely extinguished within three(3)days after ignition. 13 Fan required 0 Other 13 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 inspection. Th it/�obecomes null and void if work is not completed within 30 days. Permit includes two (2) inspections mabmum, additional ' cf ns xty four(64)dollars per inspection. X Date: Z lI C� n Owner/Owners Re rese tive/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: Ins ector TOTAL FEES