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:ate Issuea • 1 /? //9n rermlt zo Permit No. : � i0-46O-qQ - or picked_ up: CITY OF ORONO P.O. Box 66, Crystal 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. - OPEN BURNING PERMIT SITE ADDRESS: 14O V.1 12_.> DATE: I L - \ "\ -9 0 Name: � Q_ C i.� Phone: V-2a- -‘CQS3 (h) def -� g � j (o) `' (�.. . -cam-. Zip: ,,-3 Ce Mailing Address: 1-40�1- it-)o a-�o cam. � Cit Y d Agent (if applicable) : FOR THE PURPOSE OF BURNING �(,( L�+k�-, C� (7-&-‘ This application for open burning will be aomplished in accordance h the conditions listed. The recipient of the permit shall comply with all 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) will be charged a $100.00 annual fee. ) Signature e� O Ins ected b Approved by: tl"�„(.SGtihG.._.P '' Y 49t1.9 ,�_ Date: /V' 2.-2-- 50 Inspectors Comments: PGA. poe,5 /t or Ac o-J RN/'v C-A2D?1v E Minim)/.1,5 f&is lf- O :ire Department: Long Lake Maple Plain ound Wayzata The Fire Department must sign this burning permit if they will be doing the burning for the applicant. Fire Department THE FOLLOWING ITEMS -are to be completed before the inspector arrives (If inspector has to re-inspect site because items were not complete, there will be a $20.00 charge per re- inspection): 1. Street address must be posted and visible from the street. Where more than one house 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 meeting the following: - 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 locating the burn pile. 1 for 4. If these conditions are not met, the permit will be denied and you may not apply 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. `ILL SITES WILL BE INSPECTED before issuance of burning permit, subject to .availability of staff time.