> Departments > Health & Environment > Environmental Health Services > Air Quality > Burn Permit > Application Form

Burn Permit Application Form

Fields marked * are required

*Name:

*Daytime Phone:

Home Phone:

*Type of Burn:

General open burn (e.g. slash piles, typically conducted from 10/01/2011 - 05/01/2012)
Other burn types (e.g. agriculture, recreation, food, entertainment)

*Burn Dates:

Start: (mm/dd/yyyy) End: (mm/dd/yyyy)

*Location of Burn Only one address per application is allowed.
Enter the site of the burn as applicable (address OR legal description OR subdivision):

Address:	City: Zip:
Legal:	1/4 1/4 Section: Township: Range:
Subdivision:	Name: Lot: Filing:
Helpful directions to this location:

Mailing Address (if different than above)

Address:
City:	State: Zip:

*Type of Material or Burn:

*Amount:

(Piles or Cu. Ft., etc.)

Email:

(if entered, all interaction will be by email)

Attach Accompanying Photos/Files

Optionally include photos, plans, etc., relating to your application. The more explicit the photo is of what you intend to burn, the easier it will be to review. Also a good idea to include something (e.g. yardstick, rake, etc.) in the photo to give reference to the size of the material to burn. Click Browse button for each file to attach (up to 5).

Files: