2. Open Burning Permit
   This permit is an application for controlled burn to be conducted during a period of time when an open burning ban invoked pursuant to Iowa Code 100.40 is in effect. After completion, the form is to be submitted to the fire chief of the jurisdiction in which the burn is requested. It does not constitute a burning permit until signed by the fire chief.
4. First Name of Person Completing Form
5. Last Name of Person Completing Form
7. Address of Person Completing Form
9. City
10. State
11. Zip Code
13. Phone Number
15. Representing
17. Legal Description of Property on Which Burn is Requested
19. Address or Location of Burn
21. City
22. State
23. Zip Code
25. Date Burn is to Be Completed
    Date Burn is to Be Completed
26. Alternate Date Burn is to Be Completed (if Applicable)
    Alternate Date Burn is to Be Completed (if Applicable)
28. Purpose of Burn
30. Describe fire control that will be provided for this burn
32. E-Signature of Applicant*
Leave This Blank:


36. 1. Receive an email copy of this form.
37. Email address

    This field is not part of the form submission.

38. Submit

* indicates a required field