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 Phone Number*
Please enter a valid phone number.
Applicant's Email Address
example@example.com
Fire to be Ignited On/At:
SEC Section*—
TWP Township*—
RGE Range Road*—
W4
Product to be Ignited*
CONDITIONS

THIS PERMIT MAY BE CANCELLED AT ANY TIME.

Burning shall be done in compliance with the Forest and Prairie Fire Protection Act and Regulations mentioned above and included below on this permit. Once the fire is out, Landowners may be required to bury the ashes to ensure no secondary fires.

A Fire permit is only valid for the period for which it is issued. A fire permit may be suspended or cancelled at any time by the County Fire Chief. Upon receiving notice of the suspension or cancellation the person concerned shall immediately extinguish any fire set pursuant to this permit.

Permit holder must contact fire dispatch at 780-826-7446 to activate the permit before lighting their fire.

No person shall:

a) Light or cause to be lit an outdoor fire on land unless that person is in possession of a fire permit.
b) Allow any outdoor fire that is not authorized by a permit on land that is owned or occupied by him or under his control.
c) Light an outdoor fire without first taking significant precautions to ensure that the fire can be kept under control at all times.
d) Light an outdoor fire when weather conditions are conductive to a fire readily escaping out of control.
e) Fail to take reasonable steps to control a fire for the purpose of preventing it from spreading onto land other than his own.
f) Deposit, discard or leave any burning matter or substance in a place where it might ignite other matter and result in a fire.

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 the expiration of the permit or upon cancellation of the permit.
e) Have a responsible person in attendance at the fire at all times.
f) Provide adequate fire guard.
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 understand that I (the permit holder) must contact dispatch 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 before lighting your fire.

FOR OFFICE/ADMINISTRATION USE ONLY
PERMIT STATUS
Date Approved/Issued:

YearMonthDay
Date
Expiry Date:

YearMonthDay
Date
Fire Permit No. (YYYY-MM-DD—##):
Register Permit:
Notes/Additional Conditions:
Should be Empty:

Fire Permit Application Form

CONDITIONS

Fire dispatch contact number: