Trempealeau/Caledonia Fire Department
Burn Permit Application Form
Name
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email Address
example@example.com
Home Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Burning at a NON-Numbered Location?
Help describe it below
Location of Burn (Backyard, Farm Field, Campsite, Fence Line, Tree Line)
*
Materials to be burned (Tree branches, Wood Scraps, Leaves, Pine Needles, Etc)
*
Start Time (Permit Expires Two Weeks After Start Time)
*
/
Month
/
Day
Year
Date
Hour
AM
PM
AM/PM Option
Acknowledgement of Regulations
*
I understand and agree to comply with all local regulations regarding controlled burns.
I understand that I am only allowed to burn natural materials.
I acknowledge that I am responsible for any damages or injuries caused by the burn.
I understand that Trempealeau County NON Emergency Dispatch (715)-538-4351 needs to be contacted prior to igniting burn and after the burn is extinguished.
I understand that this permit expires two weeks after the 'Start Time' above.
Submit
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