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Date Issued: Q i-� �n�, Perlill' t to b� mailed:� Permit No. : or picked up: - - CITY OF ORONO P.O. Box 66, Crysta3 Bay, MN 55323 30 Minute notice shall be given to the police department prior to burning- 544-9511. Expires after 30 days from date issued. -------------------------------------------------------------------------- O P S N B II R N I P G P E R M I T --------------------------- ------ --------------�--------/--------------- SITE ADDRESS: CQ � � v�-� • DATE /�- lO � ll' d 1f /' , / �1 � Name: /f(�(� � ��GZuf'`� crJcza�Sv Phone: ��(_ 7�� (h) �� -/,�� (o) Mailing Ad ress: v �e City:� � ,G�, � Zip: S�3�� Agent (if applicab7.e) : � FOR THE PURPOSE OF BURNING� e ,;��tv�� — L.J �� ,/) 'S � Savn a c-� od� This application for open burning ill be accomplished in accordance with the conditions Iisted. The recipient of the permit shall comply with aZ I other state and local laws regarding open burning including obtaining the required permits. (NOTE : More than 5 times per year (for all organizations and individuals regardless of tax status) wil 1 be charged a $100.00 annual fee. ) �� J Signature -------------------------------------------------------------------------- Approved by: Inspected by: �..` Date: � -Z�`1(7 Inspectors Comments: Fire Department: Long Lake Map1.e Plain oun Wayzata The Fire Department must sign this burning permit if they wil7. be doing the burning for the applicant. Fire Department TH$ FOLLO�IZNG ZTBMS �are to be completed before the inspector arrives (If inspector has to re-inspect site becanse iteas rere not cosplete, tbere irill be a $20.00 cl�arqe per re- inspection): � i 1. Street address must be posted and visible from the street. Where more than one house ! i is served by the same private driveway or unnamed private road, additional sets of � numbers shall be placed at every fork or other driveway as necessary to direct � traffic to every house including the house farthest from the street. 2. Burn pile must be stacked at burn site meetinq the followinq: - Minimum 50' from buildings - Wood and paper products only - 8' maximum diameter, 4 high maximum 3. Draw a map on back side of permit application locatinq the burn pile. 4. If these conditions are not met, the permit wil 1 be denied and you may not apply for another permit for 30 days. 5. Read all conditions on backside of permit before burning. Violations of these conditions may result in the issuance of citations and permit may be revoked. AT•T• SITES WILI. BE INSPBCTED before issuance of bnrning permit, subject to availability of staff time.