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APPLICATION FOR SPECIAL WRITTEN PERMIT
Pursuant to Section 4 of the

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

1. The legal description and civic address of the property wed } U ’
it is proposed to set the fire and the exact location of the bubwiin: %
site or sites thereon: . FEB - § 1976
(a) Legal Description:Lot Six(6) of part of t Fractional SCUTH HAE (83)
(b) Civic Addresa: °F np CE TOR | ive (51 Towpeats Forty (0) Plan 7364 NwD
rs 7 ir +
(c) Exact Location of Burning Site or Sites:
Vacant Farmland at rear of property

2. (a) Name of Registered Ower:Richard Gliere and Blake Dowling
(b) Registered Owner's Consent to this Pfam:
Signature of Registered Owner— tak, Boab e ;
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(Position with Limited Company) hk (1£ abplicable)

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

2or 3 Weekdayd upon issueing of permit.

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

eet 3 AMOUNT
Small tree branches to clear farmland 9 piles 10-15 ft.in Diameter

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

io Buildines or Combustible materials within danger.
No neivrhbours neszr enourh to be affected by smoke.etc,

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

‘(a) We do not propuse to use any special method of combustion [x]
(b) The following special method of combustion is proposed:

a Fine pecans both copies to Signature of Applicant

12. Fine Department reports on reverse
side and fomwands to City CLerk, Company Name

City Clerk places on Agenda for 2024 Burns Road,Prot Coquitlam,B.C.
Councké meeting. Address

67 OU 68.
Telephone

January 30,1976
Date of Application

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