2. Application Date:*
   Application Date:
3. Type of Burn Permit Requested*

   Please select type of Burn Permit Requested

   1. Bonfire Permit
   2. Residential Burn Permit
   3. Commercial Burn Permit
   4. Other (please specify)
4. Other Permit
   If Other Permit selected, please specify what type of permit
6. Please Describe Planned Burn Activities*
8. First Name*
9. Last Name*
11. Street Number*
12. Street Name*
13. Street Type*
15. City*
16. State*
17. Zip*
19. Contact Number*
20. Email Address*
22. Property Owner Information
24. First Name*
25. Last Name*
27. Street Number*
28. Street Name*
29. Street Type*
31. City*
32. State*
33. Zip*
35. Contractor Information
37. Contractor Business Name
38. Contractor Representative Name
40. Contractor Phone
41. Email
43. Address1
45. City
46. State
47. Zip
49. Event Name*
51. Event Location*
53. Event Date*
55. Note
    Must review and follow Burn Permit Information.
56. Burn Permit Information
    Burn Permit Information
58. Acknowledgement

    1. I hereby agree

    All information is complete and accurate to the best of my knowledge and agree to comply fully with all requirements govern by the City of Waynesboro Fire Department. Failure to provide complete and accurate information shall be just cause for revocation. Applicant is responsible for scheduling required inspection(s) prior to the issuance of permit.
Leave This Blank:


60. 1. Receive an email copy of this form.
61. Email address

    This field is not part of the form submission.

62. Submit

* indicates a required field