Fire Permit Form

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  • MM slash DD slash YYYY
    I certify that I, the undersigned permittee, am eighteen years or older, that I am the owner of the land where the fire will be kindled or have the permission of the owner, and I understand the law, regulations, and my responsibilities under the terms of the permit and I will call 823-8123 (dispatch) and advise them prior to kindling the fire.