Yearly Recreational Residential Burning Permit Container Inspection

Yearly Recreational Residential Burning Permit Container Inspection
Graafschap Fire Department 4534 60 St. Holland, MI 49423
Email: chief@graafschapfire.org
All Recreational Residential Burning Permit Container Inspections EXPIRE on December 31 of each year. Recreational fires may not exceed three (3) feet in width.
YESNO
Location the compliant burning container will be used
Name
Address
Email
example@example.com
Mobile #
Format: (000) 000-0000.
I understand that this application can be revoked at any time if it is found that the approved container is not being used with the screened lid in place or as intended.
Initials of applicant:
Description of area where the Approved Container will be located.
Known Hazards near the proposed burning area.
Names and Addresses of adjoining property owners.
Name
Address
Home Phone
Format: (000) 000-0000.
Mobile Phone
Format: (000) 000-0000.
Name
Address
Home Phone
Format: (000) 000-0000.
Mobile Phone
Format: (000) 000-0000.
Name
Address
Home Phone
Format: (000) 000-0000.
Mobile Phone
Format: (000) 000-0000.
Name
Address
Home Phone
Format: (000) 000-0000.
Mobile Phone
Format: (000) 000-0000.
Has each adjoining property owner been contacted about your plan to have recreational fires?
YESNO
If yes, then by who?
Telephone
Format: (000) 000-0000.
I give permission to the Graafschap Fire Dept. to access my property to inspect my burn container.
Signature of Applicant

Clear
Should be Empty:

All Recreational Residential Burning Permit Container Inspections EXPIRE on December 31 of each year. Recreational fires may not exceed three (3) feet in width.