Permit Application
NAME: Mary Jensen
ADDRESS: 25863 Highway 69, Gardner, CO 81040
PHONE: 7197462233 FAX: Fax EMAIL: Email
BURN LOCATION: 25863 Highway 69
LANDOWNER: Mary Jensen
BURN SUPERVISOR: Tanner Martin PHONE: 801-230-9650
PROXIMITY TO PUBLIC LANDS: 0
PROXIMITY TO STRUCTURES: 25 ft
PURPOSE OF BURN: Clean yard
TYPE OF DEBRIS TO BE BURNED: Brush and branches
TOTAL AMOUNT OF DEBIRS TO BE BURNED:
AUXILLARY FUEL TO BE USED: Paper
ALTERATIVE TO BURNING: N/A
PROPOSED STARTING DATE: 03/31/2026
PROPOSED COMPLETION DATE: 04/04/2026
TOTAL DAYS, HOURS NEEDED TO COMPLETE BURN: 5
ADDITIONAL REQUESTS AND INFORMATION:
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