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2. Once this form is submitted, the Permit Coordinator will email a signed copy of the approved permit within 3 business days. However, your permit will be active from the time you click submit. Contact the Building & Planning Department with questions at: (360) 795-3067
4. First & Last Name*
5. Phone Number*
7. Address, City and Zip Code*
8. Burn Site Address (if different than above):If no address give quarter section, section, township, range and name of nearest county road
10. Email Address (Required to receive signed permit)*
12. Describe size of burn, nature of material, number of piles to be burned at one time, total number of piles to be burned, and duration of proposed burn:*
    For example: 2, 10'x10' piles of brush, branches, berry bushes and grass clippings
14. Outdoor Burning Ordinance - See prohibited materials on page 4 of the linked ordinance.
    Burning Ordinance- Please Read
15. I read the prohibited materials section of the Outdoor Burning Ordinance*

    1. Yes
17. 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.

    1. Click the checkbox to indicate that: I agree.
19. Electronic Signature*
    This permit shall be kept at the fire site at all times. This permit is only valid for 30 days.
20. Today's Date:*
    Today's Date:
22. Call Wahkiakum County Communication, (360)795-3242 to get Burning Conditions and provide the address the day of burning.
24. Large Fire Burning Permit Rules:
    1. No outdoor burning shall be done when a burn ban is in effect. 2. No outdoor burning shall be done during the declared period of impaired air quality. Burning conditions shall be obtained each day before starting to burn. 3. Burning must be done with the following clearances from structures, property lines, and other combustible materials: a. Not less than 15 feet when using an approved burning appliance. b. Not less than 50 feet for pile sizes greater than four feet by four feet but less than ten feet by ten feet. c. Not less than 50 feet from any structures regardless of pile size. 4. A person capable of extinguishing the fire shall attend it at all times and the fire must be totally extinguished before leaving it. A sufficient water supply and shovel must be at the burning site and ready to use. 5. Burning shall be conducted during daylight hours and only 1 pile may be burned at a time and it must be extinguished before starting another. 6. No fires are permitted in or within 500 feet of a forest slash and without a slash burning permit from Washington DNR. 7. If a fire creates a nuisance, it must be extinguished upon direction from the jurisdictional fire protection district., the local air pollution control authority, or the Wahkiakum County Public Works Director.
26. Printing Instructions:
    Click "Submit and Print", then right click, and select "Print".
28. Official Use Only (Below this line)
30. Wahkiakum County Signature of Public Works Director or Permit Coordinator
    This burn permit is approved by the Wahkiakum County Public Works Department pursuant to Ordinance 122-94. The large burn permit shall be approved pursuant to the following conditions:
32. APPROVED
33. DENIED
34. Signature of Public Works Director or Permit Coordinator:
35. Date:
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 Submit and Print

* indicates a required field