6. Material to be burned shall be: [ ] Piled [ ] Collected in a pit
[ ] Ignited in place (Agricultural Burning Only)
[ ] Ditch burning [ ] Placed in an approved waste burner
[“Approved waste burner’” means an incinerator constructed of fire resistant material with a cover or
screen that is closed when in use, and has openings in the sides or top no greater than one inch in
diameter.]
7. Anticipated duration per burn in hours: _______________________________________________
8. Estimated number of days to burn all material: ________________________________________
9. Purpose(s) of burning: [ ] Weed abatement [ ] Fire prevention
[ ] Range improvement [ ] Crop removal
[ ] Others (Please explain) ___________________________________
10. What types of actions will be taken to minimize fire emissions including any Emission Reduction
Techniques (ERTs)? ERTs include, but are not limited to:
Minimize the material to be burned;
Prevent fire from spreading by lining the area where open burn is conducted and
application of fire retardant foam, or water;
Allow the material to dry before burning;
Minimize soil content in slash piles by constructing piles under dry soil conditions or by
using hand piling methods;
Burn in piles;
Use a back fire when grass is burned; (back firing is burning in opposite direction of the
wind)
Extinguish the smoldering burns;
Burn before litter falls;
Burn prior to precipitation;
Other (Please provide a description of the techniques you will be using to minimize the
emissions from your open burning activities): _________________________________
________________________________________________________________________
11. Burn area must be at least 50 feet from your home, our neighbors, and business.
a. What is the distance from the burn location to your residence? ________ feet
b. What is the distance from the burn location to your neighbors? ________ feet
c. What is the distance from the burn location to nearby businesses? _______ feet
(Please note, permit can not be issued if the distance is less than 50 feet)
12. Please provide a either a hand drawn map or Google/Bing/Mapquest/county assessor or parcel
map of the burn location, depicting the burn area, traveled roads, airports, and the distance from
nearby buildings/structures (including fuel tanks, gas lines) that are under your ownership or
another person’s ownership. In your map, please use a line to note the distances between the burn
location and buildings/structures in feet. Please see the example: