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Burn Form Application - MCAQMD

Section I APPLICANT INFORMATION
Choose one permit type: *

Check at least one permit type:
residential, agricultural, or other Agricultural Residential Other
Section II APPLICATION INSTRUCTIONS

This application is not a permit to burn.
Burning vegetative matter on your property prior to obtaining a permit from the District is a violation of District Regulations and subject to penalties.
The application must be filled out completely with all statements answered.
All burning must comply with Federal, State, County, and local fire protection agency burn requirements.
Incomplete applications will delay the permit process. The District may request additional information.
You will receive a Burn Permit from the District following payment of a $19 fee.
Payment options include: Online by credit card or Mail in by check.
Required fields are marked with * .
Submit form by clicking on the button at the bottom of this form.

Section III APPLICANT INFORMATION
Applicant First Name: *

enter first name Phone Number: *

enter phone number including
area code Applicant Last Name: *

enter last name Cell Number:

enter phone number including
area code Applicant Email: *

enter email Applicant Email: *

enter email Enter email twice to confirm accuracy Property Address: *

enter address where burning City: *

enter property address city Total Acreage:

if applicable enter number of acres State: *

enter property address state Zip: *

enter mailing address zip code
If no Street Address, please provide the following information: Township:

enter township Range:

enter range Section#:

enter section# Nearest City:

enter nearest city
to burn site Assessors Parcel#:

parcel number ###-###-##
Property Owner: *

enter name if different than above Mailing Address: *

where mail is received
if different than above City: *

enter mailing address city State: *

enter mailing address state Zip: *

enter mailing address zip code
Section IV BURN PERMIT INFORMATION
Provide the following information of at least one amount - Acres, Piles or Both: *

Give an amount for at least one:
acres, piles, or tons AND / OR Burn Permit Class: *

select class of permit Total Tons

one ton is approximately
a 10'x10' pile

Section V SMOKE MANAGMENT PLAN INFORMATION

Smoke Management Plans are required in addition to a valid burn permit for burns meeting any of the following conditions: Broadcast burns cumulatively exceeding ten (10) or more acres per year; OR Burn piles cumulatively exceeding 50 tons of fuel per year;OR Less than ten (10) acres or fifty (50) tons of material, but the burning will occur in close proximity to sensitive receptors.
Is a Smoke Management Plan (SMP)Required?

enter yes for burns over 10 acres NO YES(Contact Air Quality for filing of SMPs)

Section VI COMPLETION OF APPLICATION PROCESS

Please review your information before submitting form.
Payment instructions will follow: The burn permit fee is $19.
It generally takes up to 2 weeks for processing. Once the application and payment have been processed, your burn permit will be sent to you by email.

THIS IS NOT A BURN PERMIT!!