CoTH21 - Fire Permit Application Form

Fire Permit Application Form

Apply for a fire/burn permit by filling out this form. Please provide accurate information to ensure the timely processing of your application. Missing or incorrectly entered information may result in your application being rejected.
Date (MM-DD-YYYY)*

MonthDayYear
Date
Applicant's Name*

First NameLast Name
Applicant's Email Address
example@example.com
Applicant's Phone Number*
Please enter a valid phone number.
*Mailing Address (required if no email address is provided)

Street Address

Street Address Line 2

CityProvince

Postal Code
*Please note that it may take 1-2 weeks to recieve your permit in the mail.*
Fire to be Ignited On/At:
QUARTER: *
SEC (1-36): Section*
TWP:   Township*
RGE:   Range*
W4
Nearest Fire Station
Is this property adjacent to a paved or oiled road with painted lines?*

YesNo
In the case that smoke would cause a hazard to visibility while burning, I acknowledge that "Smoke Signs" must be posted. Therefore, before igniting fire, permit holder must contact local highway maintenance contractor (Emcon) at 780-449-0502 if burning near a Primary or Secondary Highway.
Smoke Sign Acknowledgement

I acknowledge
Is the material to be burned located within 100ft of ANY road (Rge/Twp/Hwy)?*

YesNo
Please be aware that a 30ft fire guard is REQUIRED for any fires that will be lit within 100ft of a road.

I acknowledge, and agree to provide adequate fire guard.
Purpose of Burning*

Brush PilesYard Clean UpRoot PilesPipeline ROWWindrowsBalesStraw/HarrowGrassOther
If brush piles, how many (#)?
**Requested Permit Start Date:*

MonthDayYear
**All issued permits will be valid for 14 days only. Please note that same-day requests may not be processed in time.**
CONDITIONS

Extracts from the Forest and Prairie Protection Act of Alberta:

Section 19
(3) A Fire Permit is valid only for the period for which it is issued.
(4) A Forest Officer or Fire guardian issuing a Fire Permit may endorse on the Permit any special fire control conditions with which the applicant must comply in addition to the provisions of this Act and the regulations.

Section 20
A Fire Permit may be suspended or cancelled at any time by a Forest Officer or Fire guardian and upon receiving notice of the suspension or cancellation the person concerned shall immediately extinguish any fire set pursuant to the person’s Permit.

Section 21
(1) For the purpose of fire control the minister may, by order,
(a) suspend or cancel within any part or all of Alberta all Fire Permits, or
(b) prohibit the lighting or require the extinguishing of a fire set other than under the authority of a Fire Permit.
(3) In an area affected by an order made pursuant to subsection (1), every person shall immediately proceed to extinguish every open outdoor fire lit by the person or under the persons' authority and every fire located on land occupied or owned by the person.

Section 22
No person shall,
(a) light an outdoor fire without first taking sufficient precautions to ensure that the fire can be kept under control at all times.
(b) light an outdoor fire when weather conditions are conducive to a fire readily escaping out of control.
(c) Fail to take reasonable steps to control a fire for the purpose of preventing it from spreading onto land other than the person’s own.
(d) Deposit, discard or leave any burning matter or substance in a place where it might ignite other matter and result in a fire.

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Additionally, every person who sets a fire under authority of a Permit shall,

(a) Keep the Permit at the site of the fire.
(b) Produce and show the Permit to an Officer on request.
(c) Keep the fire under control.
(d) Extinguish the fire before expiration of the Permit or upon cancellation of the Permit.
(e) Have a responsible person in attendance at the fire at all times, except as may be otherwise authorized by a Fire Guardian.
Acknowledgement of Conditions*

I understand and agree to comply with all local regulations and conditions regarding controlled burns.I understand that failure to comply with the regulations and conditions may result in penalties.I acknowledge that I am responsible for any damages or injuries caused by the burn.I acknowledge that this application is not for burning a standing structure.I acknowledge that applications requesting same-day approval may not actually be approved same-day due to the time required to process each application.I understand that I, the permit holder, must contact dispatch (780-826-7446) to activate my permitI have read and understood the fire permit application requirements.
Signature*

Clear
Fire dispatch contact number:

If your application is approved, please remember to phone 780-826-7446 to activate your permit immediately prior to lighting your fire (and no earlier).

Fire Permit Application Form

CONDITIONS

Fire dispatch contact number: