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2. First Name*
3. Last Name*
5. Phone Number*
6. Email Address*
8. Address where you will be burning*
10. This address is inside the city limits*

    1. Yes
    2. If No, please contact the the Division of Forestry
11. Date you are going to burn*
    Date you are going to burn
13. Do you agree to burn only small piles leaves, limbs, and tree debris that are generated from the property where the burning will take place?*
    -- Select One --Yes, I agree.No, I disagree. I understand I am not permitted to burn.
15. Do you agree to follow the City of Portland ordinance for open burning?*
    -- Select One --Yes, I agree.No, I disagree. I understand I am not permitted to burn.
17. Do you understand the person(s) burning shall be responsible for any consequences of action or for any damages, injuries or claims resulting from such burning, and are responsible for seeing that all proper regulations, and safety precautions, are carried out?*
    -- Select One --Yes, I understand.No, I disagree. I understand I am not permitted to burn.
19. Remember to practice the following:
    • Burning is allowed between 8:00 a.m. until sundown.
    • Avoid burning when weather is dry or windy.
    • Keep a water source ready in case your fire should spread.
    • Stay with all outdoor fires until they are completely out.
    • Avoid burning when your smoke will be bothersome to neighbors.
21. Electronic Signature Agreement*

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, and 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature. 

    Burn Permit Confirmation
    Thank you for your submission. If you have completed all required fields and answered “Yes” to each of the listed questions, you are authorized to conduct open burning in accordance with the City of Portland’s Open Burning Ordinance. Please, ensure all burning activities comply with ordinance requirements at all times. The Portland Fire Department reserves the right to deny a burn permit or require an open burn to be extinguished due to weather conditions or other safety concerns.

    1. I agree.
23. Electronic Signature*
24. Date Submitted*
    Date Submitted
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26. 1. Receive an email copy of this form.
27. Email address

    This field is not part of the form submission.

28. Submit Submit and Print

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