Permit Application
NAME: Mary Jensen
ADDRESS: 25863 HWY 69, Gardner , CO 81040
PHONE: 719-746-2233 FAX: Fax EMAIL: Email
BURN LOCATION: Burn Location
LANDOWNER: Mary Jensen
BURN SUPERVISOR: Mary Jensen PHONE: 719-746-2233
PROXIMITY TO PUBLIC LANDS: N/A
PROXIMITY TO STRUCTURES: 25-30 feet from shed
PURPOSE OF BURN: remove debris
TYPE OF DEBRIS TO BE BURNED: Type Of Debris To Be Burned
TOTAL AMOUNT OF DEBIRS TO BE BURNED: 2 Piles of 8x8
AUXILLARY FUEL TO BE USED: N/A
ALTERATIVE TO BURNING: N/A
PROPOSED STARTING DATE: 10/12/2025
PROPOSED COMPLETION DATE: 10/16/2025
TOTAL DAYS, HOURS NEEDED TO COMPLETE BURN: 5 Days
ADDITIONAL REQUESTS AND INFORMATION:
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