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SPECIAL CONDITIONS: Visit DNR Website for information & dates www.dnr.state.mn.us <br /> • DNR Burning Restrictions—Yearly from approximately April 1"for 4-6 weeks. Check DNR website for dates <br /> &conditions,as they can change depending on conditions. No Orono permits will be approved during the yearly <br /> burning restrictions time period. Recreational fires are still permissible under restricted conditions during this <br /> time period. <br /> DNR Burning Bans—Declared under extremely dry conditions. No burning of any kind is allowed during <br /> DNR Burning Bans. <br /> Prohibited Materials Include: refuse,leaves, oils,rubber,plastics,tires,building materials and chemically treated materials such as <br /> railroad ties,treated lumber,composite shingles,tar paper,insulation,and composition board,sheet rock,wiring,and paint,hazardous and <br /> industrial solid waste. <br /> I AGREE: <br /> - Not to burn any prohibited materials. <br /> - Not to burn if there is a practical alternative method for disposal of material such as chipping or composting. <br /> - To use a clean burning device to start the fire. <br /> - Not to conduct burning during any air quality alert. <br /> - Not to burn paper or cardboard except as provided under Minnesota Statutes 17.135. <br /> - To have this permit available at the burn site for inspection. <br /> - That prevailing wind must be away from nearby occupied buildings and as far away from any highway or public road and controlled <br /> so as that a traffic hazard isnot created. <br /> - To keep this fire under control and assume responsibility for all damages and costs that may result from burning done under this <br /> permit. <br /> - That fires will not be allowed to smolder without flame. <br /> - To provide a water supply and an adult to attend this fire until completely extinguished. <br /> - To extinguish the fire immediately if this permit is revoked. <br /> - That no material may be brought in to be burned from another site. <br /> This permit may be revoked should any or all of the following conditions exist: <br /> 1. A fire hazard exists or develops during the course of the burn. <br /> 2. A public safety hazard exists or may exist if the burn is implemented or is allowed to continue. <br /> 3. Any conditions agreed to have been violated. <br /> REVOCATION OF THIS PERMIT WILL RESULT IN A 6 MONTH MORATORIUM ON ISSUANCE OF BURNING PERMITS TO THE <br /> APPLICANT OR FOR OPEN BURNING AT THIS PROPERTY. <br /> X fun6 `yh cv�� <br /> Sign Lure <br /> I ATTEST,BY MY SIGNATURE, THAT I HAVE READ AND WILL COMPLY WITH THE CONDITIONS OF AND ANY ATTACHMENTS TO <br /> THIS PERMIT;AND THAT I AM THE LANDOWNER OR HAVE PERMISSION OF THE LANDOWNER TO BURN AT THE ABOVE BURN <br /> SITE LOCATION. I ACKNOWLEDGE THAT VIOLATIONS OF PERMIT CONDITIONS MAY SUBJECT ME TO CRIMINAL AND/OR CIVIL <br /> ACTIONS AND/OR REVOCATION OF BURN PERMIT PRIVILEGES IN THE FUTURE. <br /> MAP <br /> , 1 4 (Lot Size ) <br /> ?)\) ) 7 Bu„,i 8011 ,1 <br /> Approved by: Inspected by: 1 Date: I ` ` g <br /> Inspectors Comments: <br /> Fire Department: Long Lake Wayzata <br /> This permit is valid for open burning as allowed and specified in State Statute 88.01 to 88.22,88.75, 88.76,Minn. Uniform Fire Code,and local <br /> ordinances. The permittee is granted permission to burn the above described materials at the specified location during the dates listed above. <br /> BtA> Y ' \Ckl ( Cs V X12 etr' jf ,.- 11- <br />