City of Victoria Form Center

2. 
3. VICTORIA FIRE MARSHAL'S OFFICE

                       9508 Zac Lentz Parkway                        

                         Victoria, Texas 77904   

                               361-485-3460

5. Burn Permit Application
7. Date*
8. Applicant Name*
10. Applicant Address*
12. Burn Location Address*
14. Contact Person*
15. Contact Person Email Address
17. Contact Person Phone Number*
18. Contact Person Cell Phone Number
20. Details regarding the above request must be filed when application is made and whenever requested by Fire Department Personnel. It is the applicant's responsibility to ensure that conditions are in accordance with applicable State and Local Laws and Regulations. I understand that it is the sole discretion of the Fire Marshal's Office to approve or disapprove this request for any reason.
22. I have received the Open Burning Requirements and agree to conduct open burning in accordance with the Fire Marshal's Office requirements. Failure to comply with the Open Burning Regulations and/or the directive of the Fire Marshal may result in the denial or revocation of the burn permit.
24. Applicant Signature *
25. Date*
Leave This Blank:


27. 1. Receive an email copy of this form.
28. Email address

    This field is not part of the form submission.

29. Submit Submit and Print

* indicates a required field