Required fields are marked with asterisks (*)

Agricultural Fire Permit Application

Please complete this application if you'd like to undertake an open-air burn on a farm property that is 61 cm x 61 cm (24” x 24”) or larger. If approved, the burn permit will be valid for the date requested as approved by Fire and Emergency services. This is a single-use permit and a new permit must be approved for each burn. The fee for the burn permit is $75 which can be paid at Severn's Administration Office when picking up your permit. You must follow all of the requirements outlined in the Open-Air Burning By-law.

Name

Street address

Municipality

Province

Postal code

Phone number

Privacy statement

Information contained on this form is collected under the authority of the Fire Protection and Prevention Act. Information collected will be used and managed by the Township of Severn in accordance with the Municipal Freedom of Information and Protection of Privacy Act for general municipal operations. If you require additional information, please view our Freedom of Information and Routine Disclosure Policy.

Please indicate that you've read and understand the above privacy statement.

Yes

Date of planned agricultural burn

Burn site address

Municipality

Province

Postal code

Burn site contact's name (if different from applicant)

Phone number

Please indicate if you are the owner or tenant of the property

Owner

Tenant

Signature

Clear

Date

Forms

Agricultural Fire Permit Application

Privacy statement