Recreational Burn Waiver

Philomath Fire & Rescue

Recreational Burn Waiver

Please enter the required information
(Information is for Philomath Fire & Rescue use only)

Today's Date (MM/DD/YY):
Person Responsible:
Address of Burn:
City/Community:
Telephone Number:
E-mail Address:
Print a copy for your records:	Print Form

(Permit is valid for one year from the date entered above)