Full Text
Open Burn Permit Application Date of Application: Name of Applicant: Company Name: Address: Phone Number: Location burning will occur: Date and time frame burning will occur: Type of material to be burned: Purpose of burning: Name of responsible person who will be on-site: Phone Number on-site: Any other relevant or necessary information explain why burning is necessary) Provide a site plan of the proposed open burn area. Include structures and fixtures that are in the immediate area. The foregoing facts are known to be true based on my personal knowledge. I agree to on-site inspection(s) by authorized personnel to verify the above stated facts and to observe the burning. I have received, read, and agree to the general conditions listed in the “Open Burning Guidelines.” Applicants Signature Date Completed by Granting Authority Only Permit subject to all conditions as indicated in the Open Burning Guidelines and as indicated on the Open Burn Permit. Application Approved Date: Signature CITY OF LARAMIE FIRE DEPARTMENT Life Safety & Fire Prevention Division P.O. Box C Laramie, WY 82073 (307) 721-5332 FAX (307) 721-5333 TDD (307) 721-5295