Application for Burn Permit

Location of Burn

Inside City Limits

Outside City Limits

Type of Request

Initial Permit

Renewal Permit

Applicant Information

Applicant Name *

Company Name

Primary Phone

Cell Phone

Fax

Mailing Address *

City

State

Zip Code

Site Information

Site Address *

County *

Name of Individual Who Will Control Burn *

Phone

Site Name *

Subdivision or Development Name *

Directions

Type of Material to be Burned

Distance to Nearest Occupied Structure

Vegetative Waste / Land Clearing

1. ONLY material originating from the above mentioned location will be burned.

2. A minimum of one portable fire extinguisher or other approved method shall be available for immediate extinguishing.

3. No burning will take place before 7:00 AM and must be completed by 5:00 PM.

4. You must receive permission from the Nixa Fire District each day of burning by calling 725-4025 or 894-0318.

5. Burning will take place at least 200 yards from all neighboring occupied structures (private/commercial).

6. Permit holder will correct all smoke problems immediately.

7. Permit holder is obligated to comply with local, county, state, and federal laws and regulations.

8. The Nixa Fire District reserves the right to revoke this permit.

Recreational / Yard Waste

1. All burning shall be supervised at all times.

2. A minimum of one portable fire extinguisher or other approved method shall be available for immediate extinguishing.

3. You must receive permission from the Nixa Fire District each day of burning by calling 725-4025 or 894-0318.

4. Burning will take place at least 50 feet from any structure without proper measure to prevent fire spread.

a. Bonfires shall not be conducted within 50 feet of a structure or combustible material unless contained in an approved container.

b. Recreational fire shall not be conducted within 25 feet of a structure or combustible material. Pile must be 3' or less in diameter and 2' or less in height.

5. Permit holder is obligated to comply with local, county, state, and federal laws and regulations.

6. The Nixa Fire District reserves the right to revoke this permit.

I have read and understand the rules listed in this permit.

Name *

Date *

Email Address *

Special Instructions

Thank you for contacting the Nixa Fire Protection District. Today's technology is fantastic however, it may take several minutes to receive your application.

When we receive your application, please allow up to 3 to 5 business days to process your request. We appreciate your patience.