Request A Burning Permit

Fields marked with * are required.
Name *		John Smith
Email *		joe@email.com
Street Address *		1234 S West St.
Burn Address *		1234 S West St.
Phone *		5176639111
Permit Type *	--RecreationalBrush
Date of Burn *	Sat 01/28/2012 Sun 01/29/2012 Mon 01/30/2012 Tue 01/31/2012 Wed 02/01/2012 Thu 02/02/2012 Fri 02/03/2012	01/01/2007
	I have read the ordinance and agree to comply. *

For questions please contact us at (517) 663-9111

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