📄 Form Input Fields

Changes reflect instantly on the official copy on the right.

1. Applicant & Location

Applicant Name

Phone Number

Permit Location / Address

Property Authorization

2. Requested Activities

Burn Permit Fireworks Permit

BURN COMPLIANCE REQUIREMENTS (SEC. 14(02))

Open air burn site (max 3ft by 3ft) Daylight hours only operation Only clean wood/brush (No garbage) Clearance: 50ft from structures & 10ft from vegetation Suppression element present (hose/water)

3. Official Processing

Reviewing Officer

Badge ID

Issue Date

Expiration Date

Permit ID Number

Review Status

Pending Review

SAN ANDREAS

FIRE DEPARTMENT

FIRE PREVENTION BUREAU • REGULATORY COMPLIANCE DIVISION

REGULATORY RECORD SAFD-68212 Class III Operational Permit

1. Authorized Permittee & Site Location

Permittee Name:

Jonathan Doe

Verified Contact Lines:

PH: 555-0199

EM: j.doe@lsmail.com

Permitted Site Address:

2046 Mirror Park Dr, Los Santos

Verification of Right-Of-Entry:

Private Property (Owned)

Authorizes the applicant to ignite, establish, and maintain open-air combustion on the specified property subject to complete adherence to the following conditions:

* CRITICAL: Operational only on declared "Permissive Burn Days". This permit is strictly revoked and invalid on "Spare the Air Days".

Penal Code Legal Acknowledgment & Liability
Any breach of the specified requirements constitutes an Infraction under SAFD Penal Code Sec. 14(02). Furthermore, if a physical violation results in an escaped fire affecting third-party persons or assets, the operator is subject to criminal prosecution under Sec. 14(04) Negligent Arson and full liability restitution.

San Andreas Fire Department • State Fire Marshal Division • Public Safety Record