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Home My WebLink AboutBRN2009-00020 - BRN Permit - 3/25/2009 BURN PERMIT Mason County Dept. of Community Development. PO BOX 186 -426 W Cedar St, Shelton WA 98584 - 360.427.9670 BRN2009 =00020_ T Issue Date Expiration Date Site Address: 2831 E MASON LAKE DR EAST GRAPEVIEW 222335200072 33 22 2 5 Parcel Number Section Township Range Fire District Applicant: MICHAEL COPELAND Address: 221 MONTE ELMA RD MONTESANO WA 98563 PH1: 426-8950 360-581-8299 360-249-5689 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: /' Lam( -'� •fdQ Signature Date **YOU MUST CALL (360) 427-7761 EVERY MORNING TO REPORT IN** BRN2009-00020 03/16/2009 PERMIT NO. MASON COUNTY BURN PERMIT APPLICATION GGL� 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 INFOR,MATIOt4 CONTRACTOR INFORMATION Owner q I KC LZPWAd Company Name M Add ess Mailing Address City Stat Zip Code City State Zip Code Phon Ph Phone Other Ph. r Contractor Reg. # Exp. I<a ;ail Address Drive�# E)GB Dfi;,=mac. # BOB PARCEL NUMBER: 3 5, 0 Sec. -33Town. 42- Rng. _Fire District Site Address(Please i Iyd Street me, nump�r and cit Directions to site 2\90 I Y(Q�I�YI �'ll(1�0 Parcel within 200'of Saltwater Lakep River/Creekp Pond[3 Wetland p Seasonal Runoff❑ StreamQ Slopes or Bluff 15% Is property flagged or addr ss d prior to inspection spection Yes/No-Will timber be,cut and sold in parcel p e aration? Yes / o Reason for land clearing: c�u W►i `' ti- 951:!4 all Is this site being converted or replanted? Yes / No Does site require FPA or 6 yr. Moratorium? Ye /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 16 this permit submittal the result of a Stop Work Notice,Correction Notice or other enforcement action? Ye /No i Burning is authorized subject to the following conditions: alid permit must be on site while burning. kThe 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. 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)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, Oh-lo-ot burn if wind is blowing from (direction) [an responsible adult and equipm2Dt shall be required to be on site and in attendance at the fire while burning. n site water required: 0Yes No rovide EXCAVATOR/DOZER(with a fire extinguisher)on site with qualified operator. rovide 24 hour fire watch. ire must be completely extinguished within three(3)days after ignition. required there upon completion of above conditions,applicant must call(360)427-9670 Ixt..2e2 fo 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. This permit/ pplication becomes null and void if work is not completed within 30 days. Permit includes two (2) inspections maximum, addi MI s��ctions II r uir fee o sixty four(64)dollars per inspection. X Date. Owner/Owners llepresentative/Contractor indicate which one ! FOR OFFICIAL USE BEYOND THIS POINT Accepted by: Date % DEPARTMENTAL REVIEW PPROVED DENIED NOTES Fire Marshal -0!5z� FEES Burn Permit Fee Site Inspection J Vi lation Fee State Fee Pre-Paid at Submittal Other EXPIRES: Date: Ins ector TOTAL FEES