City of Argonia
APPLICATION FOR PERMISSION TO OPEN BURN
This permit is subject to the terms and conditions of use
contained herein and must be produced at the request of a Fire District Representative .
Date______________________
Name ____________________________________________________________________________________________
Phone _________________________________________
Cell Phone _______________________________________
Address ___________________________________________________________________________________________
Location and Contents of Burn Site ______________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________
1.
ANY BURN BAN VOIDS THIS PERMIT.
2.
Permits are issued only for burning tree limbs, brush, clean lumber and items of natural growth such as leaves,
weeds, etc. No exceptions.
3.
Burning shall be supervised until the fire is extinguished.
4.
This permit must be available for presentation upon request to law enforcement or fire personnel.
5.
Notify 911 before burning.
This permit is valid for a period of 5 days: Begin date: ____________________ End date: ________________________
Valid from 6:00 a.m. to 9:00 p.m. of the being date to end date.
This permit if valid only under the conditions prescribed by law or by the District Chief relating to time, weather, burning specifications, firebreaks, and
staffing requirements. The Permit does not relieve the user of any legal responsibility for the safe use of fire or allow burning to be done in violation of
any State law, County ordinance, or local regulations restricting or regulating the use of fire. This permit may be temporarily NULL AND VOID
during suspension of burning by the District Fire Chief or his authorized representative.
Any person who violates the terms or conditions of this Permit shall be guilty of a misdemeanor and may
be cited as such. The expense of responses to and suppression of any emergency incident that is the result
of a violation of this Permit may be charged to the Responsible Party whose violation caused the response
of equipment and personnel.
Application Approved: _________________
Application Denied: ___________________
I own or legally control the above-described land. I agree to comply with all fire laws, ordinances, and regulations. I
understand and agree to comply with the specific terms and conditions of this permit.
_________________________________________
Permittee Signature
Date
___________________________________________
Burn Permit Officer
Date