Free Legal and Business Form L65 BP

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Fire Department Burning Permit (piles larger than 10’x10’) Sec_____________, T______________ N, R_____________ (R)(W) Subdivision________________________________ Expires___________________________________________ City/County__________________________________ In accordance with the laws of the state of Washington, the undersigned is granted permission to burn:__________________ acres of _______________________________________________________________ at the place described on this permit. Purpose of Burning: q Forest Fire Hazard Abatement q Home Premises Debris Disposal q Prevention of Fire Hazard q Silvicultural Operations q Agriculture q Other Description of specific area where burning will be done_______________________________________________________ ___________________________________________________________________________________ Burning is authorized subject to the following conditions: q Construct a fire break ________ feet wide to mineral earth around material to be burned before lighting fire. q Have a minimum of _______ adult persons in attendance ready to assist at the fire while burning. q Provide the following water requirements:__________________________________________________ q A burning plan is attached herein and is part of this permit. q Permittee must not leave fire unattended until extinguished. q Do not burn if wind is from the ____ and/or is blowing more than _______ mph. q Burning is subject to the fire laws and the Smoke Management Plan currently in effect. q Contains no vegetation, lumber or wood products that have been painted, stained, treated, preserved, or soaked with oil or grease. q If the fire creates a nuisance from smoke or fly ash, it must be extinguished immediately. q This permit may be suspended or canceled when deemed necessary for the protection of life, property or air quality. q Other___________________________________________________________________________________________ ___________________________________________________________________________________________________ ___________________________________________________________________________________________________ The permittee agrees to furnish sufficient help and equipment at his/her expense to suppress the fire if it escapes from and becomes or causes a nuisance and further agrees to pay the fire department for all reasonable expenses incurred in such suppression. Issued to ________________________________________ Permittee Signature________________________________ Address _________________________________________ Issued by ________________________________________ Phone No. _______________________________________ Title ____________________________________________ City/State/Zip ____________________________________ Department ______________________________________ SUBJECT TO CANCELLATION Permittee - Original, Fire Department - Canary/Pink copies 5/98

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