Temporary Open Burn Permits Application - Picture Rocks Fire & Medical District

Fill in the fields or print clearly. * Required. Attach an extra sheet if more space is needed.

Applicant full name(Required)

First Last

Business / organization (optional)

Phone(Required)

Email address(Required)

Enter Email Confirm Email

Burn date(Required)

Will you supervise the burn?(Required)

Yes

Responsible person name

Responsible person phone

Amount of day's needed for the permit(Required)

One Day

Three Day (consecutive)

Property & burn location

Full name of Responsible Party(Required)

First Last

Burn site street address(Required)

Street Address Address Line 2 City State ZIP Code

Site within Picture Rocks Fire & Medical District?(Required)

Yes

Not sure

Read every condition before completing the acknowledgment and signature on page 4.

Conditions for an authorized burn

An issued permit and any current restrictions control whether a burn may occur.

MINIMUM CLEARANCE 50 feet MAXIMUM PILE 4 ft x 4 ft WIND RANGE 5-15 mph Permit and materials. Keep the issued permit in your possession while burning. Burn only the materials authorized on that permit. Construction materials such as lumber, plywood, linoleum, and counters are not allowed. Seasonal burning hours. October 1 through March 31: 11:00 a.m. to 4:00 p.m. April 1 through September 30: 7:00 a.m. to noon. The applicable hours may change during a three-day request that crosses a seasonal boundary. Wind. While burning, wind speed must be at least 5 mph and no more than 15 mph. Weather or air-quality restrictions may prevent burning even within this range. Attendance and control. The burn must be constantly attended. Keep reasonable control tools on hand at all times, including at least a shovel and a water supply. Extinguishment. Completely extinguish the fire when burning is completed or the permitted time expires. Do not leave a smoldering fire. Pile size and clearance. The burn pile must be at least 50 feet from any structure, dwelling, or other combustible material. The pile must be no larger than 4 feet by 4 feet. Property authority. Do not burn on public land or land not owned or leased by the permittee without written permission from the owner or land manager. Cancellation. The District may cancel the permit because of weather, ADEQ alerts, or PDEQ alerts. The permit provides no refunds or extensions if it is revoked. Nuisance and prohibited materials. Burning that creates a nuisance or noxious fumes is forbidden. Do not burn food-related garbage or packaging; oleander, poison oak, poison ivy, or poison sumac; petroleum products or their containers (including oils and asphalt shingles); tires, plastics, or other synthetic materials; hazardous materials or their containers. Prohibited hazardous examples include pesticides, arsenic, lead, cadmium, mercury dimethyl sulfate, acrolein, carbon disulfide, vinyl chloride, ethyleneimine, methyl chloride, ethylene oxide, electrical wire insulation, ammunition, explosives, and other materials reasonably recognizable as sources of hazardous emissions. ADEQ: Arizona Department of Environmental Quality. PDEQ: Pima County Department of Environmental Quality.

Acknowledgment & District Review

Complete the applicant acknowledgment. Leave the staff-use section blank.

Acknowledgment of liability

I understand that an issued permit does not relieve me from complying with other applicable legal requirements. I acknowledge possible full liability for unintended consequences of a fire authorized by the permit, including response costs incurred to control the fire or protect life and property. Such liability may exist whether the permitted area or an area affected by an uncontrolled fire is inside or outside the responding fire agency's territory.

Applicant certification & signature(Required)

I certify that the information in this application is accurate and that I have legal authority to start and maintain an open fire at this location, including written permission when required.

I have read the temporary burn permit conditions and acknowledgment of liability above. I understand that all applicable conditions must be met before and during any authorized burn.

I understand that this application acts as a permit when accompanied with proof of payment or exemption.

By typing or signing my full name below, I intend it to serve as my acknowledgment of this application and the statements checked above.

Applicant full name / signature(Required)

First Last

Applicant Signature(Required)

Date signed(Required)

Burn Permit Fee Selector(Required)

1 Day ($5)

3 Day ($9)

Military/First Responders (Free)

Credit Card(Required)

Secure Payment Notice: Payments are processed securely through Stripe. Picture Rocks Fire & Medical District does not store your full card information on this website.

Billing Address(Required)

Street Address City State ZIP Code