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

Pre aw gee e at cy -¢ :