APPLICATION FOR SPECIAL WRITTEN DERI rf "y
Pursuant to Section 4 of end y

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

The legal description and civic address of the property Ron RA
it 1s proposed to set the fire and the exact location of the burning

site or sites thereon:
(a) Legal Description:
(b) Civic Address: 2 «yy CO Rees ey
(c} Exact Location of Burning Site or Sites:

(a) Name of Registered Owner: MR Vitite CA CRANT
(b) Registered Owner's Consent to this Application:
Signature of Registered Owner CC LY. Ptr He
(Pesition with Limited Company) (4£ applicable)

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

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

TYPE AMOUNT

Loar ey LR Ot eld hauser
Mr Ret pn we TS

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

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6. Whether or not some special meshog o£ 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:

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PROCEDURE
rear . CL toes.
1. Complete and submit both copies to Signature of Applicant

Fine Department.

2, Fine Department Acports on reverse
side and forawards to City Clerk, Company Name -

3. City Clerk p£aces on Agenda for RYZaO Buens RO.
Council meting. Address

Boe -JY7TY
Telephone

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Date of Application