Burn Permit Application » City of Busselton

Applicant Details

First Name*

Last Name*

Street Address*

Suburb*

Postcode*

Phone Number*

Email Address*

Burn Details

Location of the burn*

As Above
Other

If you selected "other", please provide the location below

Proposed date of burn*

To be fully extinguished by*

Please select what you plan to burn?*

Please note, if you select option 1) or 2) a permit will be issued to your nominated email address. As part of this application, you understand that you will not commence the burn until the Permit has been issued.

If you selected option 3), option 4) or 5) you will need to wait to be contacted by an Officer of the City of Busselton before a permit can be issued. As part of this application, you understand that you can't commence the burn until this has happened.

1. Garden waste piles in 1m square or less
2. Garden waste in piles of 10m square or less
3. An area less than 1ha of "stubble" or other low ground fuel
4. An area less than 1ha of natural bush
5. An area greater than 1ha

Attach images of the burn area*

Max File Size: 10.00 MB
Allowed File Types: .avi, .doc, .docx, .gif, .jpeg, .jpg, .mov, .mp3, .mp4, .mpeg, .mpg, .pdf, .png, .ppt, .pptx, .xls, .xlsx

Acknowledgement of Regulations

Please select the following as acknowledgement of the regulations*

I understand and agree to comply with all local regulations regarding controlled burns.
I understand that failure to comply with the regulations may result in penalties
I acknowledge that I am responsible for any damages or injuries caused by the burn.
I have read and understood the burn permit requirements.
I understand that if a Permit is issued, it is my responsibility to ensure that the burn is fully extinguished and I will have measures in place to ensure it does not escape the boundary of my property.
I understand that if a Permit is issued that I will comply with the conditions under the provisions of the Bush Fires Act 1954 and any conditions set by the City Fire Control Officer
I understand that this is NOT the permit to burn and that i will not commence the burn until I have been contacted by an Officer of the City of Busselton and/or a Permit has been issued

Signature*

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