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2. First Name*
3. Last Name*
5. Address of Open Burn*
6. Address 2
8. City*
9. State*
10. Zip*
12. Phone Number*
13. Email
15. Disclosure*

    I have read and understand the Open Burning Policy. Furthermore, I understand that if I choose not to follow said rules I will be subject to having my open burning privilege revoked and I will be issued a citation. Citations for illegal burning range from $100 to $1,000 plus court fees.

    1. Check here if you agree.
17. Wind Speed Disclosure*

    I understand that it is my responsibility to monitor the wind speed. If, at any time, the wind speed reaches or exceeds 10 mph, I understand that the permit will be void; and it is my responsibility to extinguish the fire immediately.

    1. Check here if you agree.
19. Wind Speeds
    Current Wind Conditions
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21. 1. Receive an email copy of this form.
22. Email address

    This field is not part of the form submission.

23. Submit

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