Burn Permit Form Step 1 of 5 20% Name* First Last Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Phone*Email Please select which type of permit you desire. Small permits are good for one calendar year. Large permits are good for two weeks from the date of receipt.*Small Residential Outdoor Fire PermitLarge Residential Outdoor Fire Permit Burn Ban MapIn order to receive a permit, your burn location must be outside the Burn Ban Zone, shown in yellow on the Burn Map.* I have reviewed at the burn map and testify that the location I have listed above is outside the burn ban zone. You must meet the following criteria in order to qualify for a permit: I testify that I am the owner of this parcel. Note: If you are a tenant, the landlord/property owner must complete this application. The law requires owner permission prior to burning. You must have the permit on the premises while burning.* I am a tenant and testify that I have received permission from the property owner to burn on this parcel. * I testify that there is a residence on this parcel. Please agree to the following:* I agree to comply with the above rules and regulations for outdoor burning. * I agree to comply with the provisions of WAC 173-425, RCW 70.94 and other applicable county or municipal codes regarding outdoor burning and I acknowledge responsibility for any claims arising from activities performed under this burning permit. * Before I burn, I will check the status of burn bans in Central Kitsap (360-447-3555). * I understand that this permit can be cancelled or revoked at any time by Central Kitsap Fire and Rescue or any other governing agency.