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CITY OF FRIDLEY FIRE DEPARTMENT
Office of the Fire Marshal
6431 University Avenue, N.E.
Fridley, Minnesota 55432
Telephone: (763) 572-3621 or (763) 572-3612
Facsimile: (763) 572-8825
Minnesot
a State Fire Code
Business Operations Permit
Application
(Temporary Activity)
Requested Permit Operation, Process or Activity: Burning of brush piles in interior of nature center
park.
Business Name (Site of Proposed Permit Activity): City of Fridley at Springbrook Nature Center
Site Address, City, State and Zip: 100 85th Ave NE
Fridley, Mn 55432
Site
Contact Person and Telephone: Siah St. Clair
763-572-3589
Director, Springbrook Nature Center
Contractor Name & Address: Nature Center employees will conduct the burn.
Contractor
Telephone:
See Site contact person
Facsimile Telephone: City’s fax
763-571-1287
On - Site Activity Telephone:
(For Fire Department Use Only) See site contact above-763-572-3588
State
Contractor License # or
ERC ID # (Hazardous Materials, if applicable):
Permit Fee (see reverse side for fee schedule):
Dates of Requested Permit Operations, Processes or Activities:
__February 6, 2009__________ to _February 20, 2009__________
Permit, if granted, is subject to compliance with applicable codes, ordinances and regulations governing the above-described
operations. Permit is non-assignable and shall be maintained in the place of business or site for which this permit is granted. It shall be the responsibility of the permittee to contact
the Fire Marshal's Office for final inspection of the permitted activity prior to initiation of the permitted activity.
Special stipulations or requirements, if any, shall be listed
in a Business Operations or Activities Permit Review included with the permit.
February 5, 2009
Siah L. St. Clair
________________________________ ______________________________________
Date
Permit Applicant