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Burn Permit Application
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Village of Lombard
Open Burning Permit Application
Burn time to be no longer than 3 hours. Termination to be no later than 11:30PM.
Date of Application
Date of Burn
Applicant Name
Applicant Address
Day Phone Number
Evening Phone Number
Fax Number
Email Address
Are you the property owner?
Yes
No
If "NO", applicant hereby confirms that the property owner is aware of this application; has given permission to applicant to file this application; and has executed this application either in person or by electronic signature.
Property Owner Name
Property Owner Address
Day Phone Number
Evening Phone Number
PERMISSION IS HEREBY GRANTED TO THE APPLICANT TO BURN ON THE PROPERTY AS STATED HEREIN THIS APPLICATION.
Property Owner's Signature/Name
Address & Location of Fire
Purpose of Open Fire
Size of Open Fire
Type of Material to be Burned
Type of On-Site Fire Extinguishing Equipment
Hours of Burn
For Office Use Only
Fire Chief or Fire Marshal
Copies to: Applicant, Fire Stations, DuComm, & Lombard Police Department
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