APPLICATION FOR SPECIAL WRITTEN PERMIT
Pursuant to Section 4 of the

“CITY OF PORT COQUITLAM FIRE PREVENTION BY~LAW, 1968, No. 902"

it is proposed to set the fire and the exact location of the bhirnifg
site or sites thereon:

(a) Legal Description:20 7-37, P./ - Dik EB 23 1876
(b) Civic Address: //7 42 TAY) DR SIFT? LOLRT. COOL TL. AAS
{c) Exact Location of Burning Site or Sites: 2 /i/ ARO PK

LOT. Ly the cenren of Jot.

1, The legal description and civic address of the Property upfn ey

2. (a) Name of Registered Gwner: LURE LIIRG. DP PAA D7
(b) Registered Owner's Consent to this, -Applicafion:
Signature of Registered Owner J f, Vf lez
(Position with Limited Company) a (i£ applicable)

3. The days and the times of those days upon which it is proposed to
have the fire burning: . .

4. The type or types of material proposed to be burnt and a reasonably .
accurate estimate of the amount of such material:

TYPE - . AMOUNT

BRAC ES VF SCRUIS Affe.
PPS Ft 49j26 2

7

5. The methods proposed to control er abate any possible spread of fire
or other danger or nuisance:

. KEEL fire Ye, £e 2 POLI ASIVE 3, But feeling
LE Sb te Ln dt fe MC pe weet Et Chis firme
ot Meta fn, Lirue Else Prebelbpirty ef fire BP reading
(o very sow.

6. Whether or not some special nethog of combustion is proposed to
promote a "smokeless" fire: ° :

“(a) We do not propose to use any special method of combustion [+

(b) The following special method of combustion is proposed:

“PROCEDURE LV anne Uy, Mn. Mees

1, Complete and submit both copies to Signature of Applicant”

Fine Department,

'2, Fine Department reports on reverse
| $£de and forvards to City Clerk. Company Name

13. City Clerk places on Agenda for 92-2960 -§ BES VANE:

Council meeting. Address

Y 3Y — 174430
- Telephone .
teh £2126

Date of Application