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St. Anthony Fire Department Application for recreational/campfire permit

  1. Fire Department Badge
  2. City of St. Anthony Fire Department
    3505 Silver Lake Rd NE St. Anthony, Minnesota 55418 Phone: 612-782-3403 or 612-782-3400 Fax: 612-781-0594
  3. APPLICATION FOR PERMIT
    RECREATIONAL / CAMPFIRE
  4. BURN SITE INFORMATION
  5. OTHER PROPERTY OCCUPANTS AUTHORIZED
    Must be 18 years of age and older. At least one of the persons named below must be in attendance at all times of the burn.
  6. NAME OF PROPERTY OWNER IF NOT LISTED ABOVE
  7. As property owner for the above address, I allow those persons listed on this application to conduct recreational / campfires as stipulated in the permit.
  8. Electronic Signature Agreement
    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.
  9. I, the undersigned, a legal adult of eighteen (18) years of age or older and the legal representative of the above listed property; understand this permit does not release me of any liability for damages that may result wherefrom. I understand and have received a copy of the recreational/campfire regulations. I agree to comply with all the requirements. A person violating any provision of this permit is guilty of a misdemeanor.Issuin
  10. Electronic Signature Agreement
    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.
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  12. This field is not part of the form submission.