Forest Land Controlled Burn Permit Request Form
Applicant Name
Organization (if applicable)
Contact Phone Number
Email Address
Location of Burn (address or GPS coordinates)
Total Land Area to be Burned (acres or hectares)
Requested Burn Date
Purpose of Burn
Type of Vegetation/Fuel to be Burned
Fire Safety/Control Plan Description
Local Authority Approval Status
Pending
Approved
Not Approved
Additional Comments or Information