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2. 
4. 
6. 
8. Please Check the Box Below*

   1. I acknowledge that I have read the rules and regulations for the Town of Colchester's Burn Ordinance; AND
10. Please Check the Box Below*

    1. I acknowledge that it is unlawful to burn without approval by the Fire Warden and that the Fire Warden will call with a permit number prior to burning; AND
12. Please Check the Box Below*

    1. I will call the Burn Permit Informational Line at 264-5570 and listen to the recording prior to burning in case burning is cancelled/not permitted for that day.
14. First Name*
15. Last Name*
17. Address*
    Location of where you'll be using the permit.
19. Phone Number*
20. Email*
22. BURN PERMITS ARE VALID FOR 14 DAYS FROM DATE OF APPROVAL
24. LEAVE THE SECTION BELOW BLANK
26. Permit Number (Issued by Fire Warden)
27. Date Issued
29. POLICE ONLY

    1. Dispatch Entered
Leave This Blank:


31. 1. Receive an email copy of this form.
32. Email address

    This field is not part of the form submission.

33. Submit Submit and Print

* indicates a required field