MINNESOTA OPEN BURNING PERMIT
COTTAGE GROVE FIRE DEPARTMENT
Please mail permit along with a check to:
Cottage Grove Public Safety Attn: Burn Permit
12800 Ravine Parkway So.
Cottage Grove, MN 55016
PERMITTEE INFORMATION BURING PERMIT CONDITIONS
NAME PILED MATERIAL:
ADDRESS TREES BRUSH
CITY OTHER (SPECIFY)
STATE ZIP # OF PILES
TELEPHONE # APPROXIMATE PILE SIZE
Email signed permit to:_____________________________________________________
BURN SITE LOCATION RUNNING FIRE FUEL:
ADDRESS PRAIRIE GRASS
CITY SIZE OF AREA
COUNTY SPECIAL CONDITION
PRIOR TO BURNING YOU MUST CALL: 651-439-9381
EFFECTIVE DATES: FROM: M/D/Y TO: M/D/Y
DAILY HOURS: FROM: AM/PM TO: AM/PM
****DAWN UNTIL DUSK UNLESS OTHERWISE NOTED ABOVE****
This permit is valid for open burning as allowed and specified in Minnesota Rules 7005.0705 to 7005.0805, Minnesota Uniform
Fire Code and local ordinances. The permittee is granted permission to burn the above described material at the specified
location during the dates and times as listed above.
Attest, by my signature, that I have read and will comply with the conditions of and any attachments to this permit and that I am
the landowner or have permission of the landowner to burn at the above burn site location.
PERMITTEE’S SIGNATURE DATE AUTHORITY SIGNATURE / DATE
COTTAGE GROVE FIRE DEPT