APPLICATION FOR SPECIAL WRITTEN PERMIT
Pursuant to Section 6 of the

"CITY OF PORT COQUITLAM FIRE PREVENTION BY-LAW,

1. The legal description and civie address of the property upon which
it is proposed to set the fire and the exact location of the burning
site or sites thereon:

(a) Legal Description: <07- Mf an GRPS Disr hg -2S5¢ 39V Final SEIEP
{b) Civic Address: 1092 CONNAUGHT OR
(c) Exact Location of Burning Site or Sites: LENTLE OF Aor

2. (a) Name of Registered Owner: Slow @ Mears Sars
(b) Registered Owner's Consent to this Application:
Signat:.re of Registered Owner «£60 c/a LPs,
74 ~

(Position with Limited Company) (1£ applicable)

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

DTARCH Ge - {0 th SFC Berweent F060 Bhd AND S100 pd
he Stole get T ive SAVE Pend FDA beg

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

TYPE : . AMOUNT

BRISHAE CLEARED DEBRIS . AAPRREM «iB CoRAS

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

eSATA FRE rtd CON STAN I URVALLLANLE

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

PROCEDURE
1. Compete and submit both nopies to
Fire Department. .
2. Fine Department reports on reverse lows & Heeattrrti ert
sdde and forwards to City Clerk, Company Name

3. City Clerk places on Agenda for AS) EPPS hve A Vans couvert,
Counce meeting. Address

929- SPS 2
et : racvae Telephone

Date of Application