APPLICATION FOR SPECIAL WRITTEN ¥
Pursuant to Section 4 of th

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

I. The legal description and civic address of the propert} AR on EEE ae 15 197¢
it is proposed te set the fire and the exact location of the burning
site or sites thereon: .

(a) Legal Description:
(b) Civic Address: YD Rrioeye 2D PERT Ceg.
(c) Exact Location of Burning Site or Sites:

(a) Name of Registered Owner: ZAR dative CY CRANT
(b) Registered Owner's Consent to this Application:
Signature of Registered Owner LC HY ot Lea
(Position with Limited Company) _ (4f applicable)

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

A " . .
bl 9092 Cy nat = Re 30

4

The type.or types of material Proposed to be burnt and a reasunably-
accurate estimate of the amount of such material:
RR AMourr

LOM BER Shem 6 /d “feuse=

Ad Ck tte ping S

5. The methods propused to control or abate any possible spread of fire
or other danger or auisance: ; Looe

SADA ELE Ss

6. Whether or not some special methogr arf 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

fi _—_—— . C BS, Lew
1. Complete and submit both copies to Signature of Applicant
+

Fine Department.

2. Fine Department reports on ALVCASE. -
side and fomands to City Clerk. Company Name

1 3. City Clerk places on Agenda for RY2Zo Bvens KL).
Council meeting. Address

Cae -2u¥7Y
Telephone

aie F& 74
Date of Application

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