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Burn Permit

2. $35 Resident

4. Date
   Date

   Date

6. Applicant Name

8. Address

10. City

11. State

12. Zip Code

14. Phone

15. Date of Burn
    Date of Burn

17. Location of Burn

19. Time Requesting to Burn

21. Requestor's eSignature

23. Please note:
    <strong>This is not a permit.</strong> It is only a request for a permit. Burning is <strong>prohibited</strong> until a signed burn permit is obtained from the Fire Marshal or designated representative. Failure to comply with the City established ordinances can be punishable of a fine not to exceed $2,000 per violation per day.

    This is not a permit. It is only a request for a permit. Burning is prohibited until a signed burn permit is obtained from the Fire Marshal or designated representative. Failure to comply with the City established ordinances can be punishable of a fine not to exceed $2,000 per violation per day.

25. Permit Number

26. Form Accepted By:

27. Date
    Date

Leave This Blank:


28. 1. Receive an email copy of this form.
29. Email address

    This field is not part of the form submission.

30. Submit

* indicates a required field