HomeMy WebLinkAbout15. 15-57 FEBRUARY 10, 2015 15-57 ORDINANCE
FIRST READING
(CARRIED LOST LAID OVER WITHDRAWN )
PURPOSE: ADOPT ORDINANCE TO ALLOW NATURAL PRAIRIE
PRESCRIBED BURNING AND REPEAL CHAPTER 21 POLLUTION
INITIATED BY: FIRE DEPARTMENT
A GENERAL ORDINANCE OF THE CITY OF OSHKOSH CREATING SECTION 13-2(C)
PERTAINING TO NATURAL PRAIRIE PRESCRIBED BURNING AND REPEALING
CHAPTER 21 POLLUTION
WHEREAS, natural prairie restoration, reconstruction and plantings have been
undertaken by various persons and entities within the City of Oshkosh; and
WHEREAS, prescribed burning is a recommended tool for the maintenance and
care of natural prairies; and
WHEREAS, current municipal ordinances generally prohibit burning within the City
of Oshkosh; and
WHEREAS, the City of Oshkosh has adopted the International Fire Code(IFC)2009
which would allow conducting natural prairie prescribed burning with an appropriate permit
issued by the local fire department; and
WHEREAS, City staff has reviewed the requests for burning and the applicable
laws, recommendations and best practices for conducting natural prairie prescribed
burning; and
WHEREAS, the Oshkosh Fire Department working with stakeholders and experts in
the community has developed a policy for the issuance of permits and supervision of
Natural Prairie Prescribed Burning within the City of Oshkosh; and
WHEREAS, the City of Oshkosh Municipal Code contains Chapter 21 Pollution
which has not been enforced for many years, is outdated and is covered in part by the
provisions of the Fire Prevention Code and in part by provisions enforced by the State of
Wisconsin Department of Natural Resources; and
WHEREAS, City staff recommends the repeal of Chapter 21 Pollution.
NOW, THEREFORE, The Common Council of the City of Oshkosh does ordain as
follows:
FEBRUARY 10, 2015 15-57 ORDINANCE
FIRST READING CONT'D
SECTION 1. That Section 13-2(C) of the Oshkosh Municipal Code pertaining to
Natural Prairie Prescribed Burning is hereby created to read as follows:
(C) Pursuant to International Fire Code (IFC) 2009 Chapter 3 Section 307 Open Buming,
Recreational Fires and Portable Outdoor Fireplaces which is hereby adopted, there is
hereby established a Natural Prairie Prescribed Burning Permit to be issued by the Chief of
the Oshkosh Fire Department or his/her designee. The Oshkosh Fire Department shall
adopt an official policy defining those areas where prescribed burning will be allowed in the
City of Oshkosh and establishing the procedures to be followed to ensure the health and
safety of the citizens and protection of property within the City of Oshkosh. Natural Prairie
Prescribed Burning shall only be conducted in accordance with a permit issued by the
Oshkosh Fire Department. Any burning without a permit or any burning not in accordance
with the terms of a permit issued by the Oshkosh Fire Department shall be a violation of
this ordinance. The Fee for a Natural Prairie Prescribed Burning Permit and any services
provided by the City of Oshkosh related thereto shall be established by Resolution of the
Common Council.
SECTION 2. That Chapter 21 of the Oshkosh Municipal Code pertaining to Pollution
is hereby repealed.
SECTION 3. This ordinance shall be in full force and effect from and after its
passage and publication.
SECTION 4. Publication Notice.
Please take notice that the City of Oshkosh enacted ordinance #15-XX ADOPT
ORDINANCE TO ALLOW NATURAL PRAIRIE PRESCRIBED BURNING AND REPEAL
CHAPTER 21 POLLUTION, on February 24, 2015. The ordinance repeals Chapter 21 of
the City of Oshkosh Municipal Code pertaining to Pollution. The ordinance creates a
municipal ordinance to permit Natural Prairie Prescribed Burning as permitted by and in
accordance with policies adopted by the Oshkosh Fire Department defining areas where
prescribed burning will be allowed in the City of Oshkosh and establishing the procedures
to be followed to ensure the health and safety of the citizens and protection of property
within the City of Oshkosh. Burning without a permit or burning not in compliance with the
terms of a permit issued by the Oshkosh Fire Department is prohibited. The ordinance
allows the Fire Department to establish fees in connection with the permit issuance and
services provided in connection with a permit through resolution adopted by the Common
Council.
The full text of the ordinance may be obtained at the Office of the City Clerk, 215
Church Avenue and through the City's website at www.ci.oshkosh.wi.us. Clerk's phone:
920/236-5011.
CITY HALL
215 Church Avenue
P.O.Box 1130
Oshkosh,Wisconsin City of Oshkosh
54903-1130
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QIHKQlH
TO: Honorable Mayor and Members of the Common Council
FROM: Tim Franz, Fire Chief
Lynn Lorenson, City Attorney
DATE: February 5, 2015
RE: Request to Create Municipal Ordinance to Permit Natural Prairie Prescribed Burning
and Repeal Chapter 21 Pollution
BACKGROUND
Natural prairie areas have been increasing in popularity for a variety of reasons and several have
been developed within the City of Oshkosh. One of the maintenance tools for these areas is
prescribed burning which is used to control weeds and promote growth of desired vegetation.
Current municipal ordinances generally prohibit this type of burning within the City.
ANALYSIS
This past year, Oshkosh Fire Department assembled a group of stakeholders and experts in the
community to develop a policy for the issuance of permits and supervision of Natural Prairie
Prescribed Burning within the City of Oshkosh. This group included persons with natural prairies
in the City, a certified prairie burning incident manager and instructor, the Winnebago County
Health Department and City staff. This group reviewed applicable laws, recommendations and
best practices for conducting natural prairie prescribed burning. With this information a policy
and permit was developed defining areas where prescribed burning will be allowed in the City of
Oshkosh and establishing the procedures to be followed to ensure the health and safety of the
citizens and protection of property within the City of Oshkosh.
During the review, staff noted that the City of Oshkosh Municipal Code contains Chapter 21
Pollution which would be in conflict with permitting this type of burning due to the smoke
created. Our review concluded that this ordinance is outdated and is covered in part by the
provisions of the Fire Prevention Code and in part by provisions enforced by the State of
Wisconsin Department of Natural Resources. It appears that this Chapter has not been enforced
or used in many years. Based upon this review, staff recommends repealing Chapter 21 at this
time.
+CS
FISCAL IMPACT
A fee is recommended for the permit which covers staff time for permit review along with pre-
and post- burn inspections. The fee is structured to recover the cost for these services, therefore
this service would be of neutral impact to the budget.
RECCOMENDATION
We recommend that the City amend the Fire Prevention Ordinance Chapter 13 Pursuant to
International Fire Code (IFC) 2009 Chapter 3, Section 307 Open Burning, Recreational Fires
and Portable Outdoor Fireplaces to establish a Natural Prairie Prescribed Burning Permit to be
issued by the Chief of the Oshkosh Fire Department or his/her designee. We also recommend
that Chapter 21 of the Oshkosh Municipal Code pertaining to Pollution be repealed. Please direct
any question regarding this matter to the Fire Chief.
Respectfully Su itted, Approved:
.-. -;r , /t
� �r��" �
Timothy Franz City Manager
Fire Chief Mark Rohloff
� �
'�v �--
Lynn Lorens
City Attorney
POLICY 701.00 March 1, 2015
701.00A SUBJECT: Natural Prairie Prescribed Burning
Effective date: 3-1-15 Revised date:
701.00B PURPOSE: The purpose of these rules are to define the areas where prescribed burning of
natural prairies will be allowed in the City of Oshkosh and outline the procedures to be followed
to ensure the health and safety of citizens and their property.
701.00C RESPONSIBILITES: The Fire Chief shall ensure that this policy is properly followed by the
responsible party designated on the permit for each prescribed burn.
701.00D ACTION: Where allowed:
1. Parcels of no less than one acre.
2. 50 feet from any point of the burn area to a structure. (IFC 307.4)
3. Potential downwind areas (within 1,000 feet of the fire area) would need to be of 1,000
persons or less per square mile population density. (This is wind direction based and if
proper conditions an area may be allowed to burn, say for example Menominee Park if
the wind is from the west).
4. Fire area must be 2,500 feet or more upwind from sensitive occupancies such as
hospitals, medical clinics, nursing homes, schools, licensed daycare centers or any
occupancy that reports after notification of the potential controlled burn that they have
legitimate hardship to their facility if they were to be in a smoke path, based on the effect
to residents or the affect on work process.
Application for Permit: A permit (Appendix D) will be required with at a thirty (30 )day notice
and will require the following information:
1. Detailed description and map of the area involved and specifically defined prescribed
burn area.
2. Proof of ownership or letter from the property owner giving their permission for the
prescribed burn.
3. The date and times the burn is anticipated to occur(may submit a seven day window)
a. Burns will be approved to take place during normal business hours on weekdays
and Saturday mornings.
4. Detailed information on the personnel or contractor and their qualifications for
conducting a prescribed burn(Appendix A).
5. A plan for notifying the neighbors immediately adjacent to the burn and potential
downwind neighbors within 1,000 feet downwind of the burn.(Appendix B)
a. The City shall provide an address list based off the described area and potential
downwind area.
Policy 701.00 Page 2
03/O1/15
6. A permit may be denied if a person or business within the downwind area has a bonafide
health issue ar business hardship due to smoke that cannot be accommodated in a
reasonable manner.
7. Assumption of liability statement and proof of insurance of property owner and/or
contractor. (Appendix C)
8. A burn plan prepared by a person trained to s-3901evel in accordance with the National
Wildland Coordination Group.
9. A list of fire control resources required to be present on the day of the burn which at
minimum will include (additional personnel and resources may be required at the
discretion of the Oshkosh Fire Department):
a. Four trained personnel (Appendix D)
b. A brush/grass fire apparatus (Type 6) with minimum 150 gallon water supply,
pump, and 300 feet of one inch hose line with nozzle.
c. 2 fire brooms/swatter.
d. 1 back pack portable water fire extinguisher with 2.5 gallons or greater capacity.
e. Minimum 2 Portable radios
f. Cell phone ar radio to contact Winnebago County Comm. Center
g. Appropriate hand tools
h. Mobile device for measuring Temperature wind speed and relative humidity.
i. Haynes Index
Pre-Burn Inspection: After submission of the application and burn plan, the person designated as
the lead for conducting the prescribed burn shall:
1. Contact the Fire Department so an Inspector or Fire Company will be notified as required
in the permit and will meet with the person in charge of conducting the burn on site.
2. The pre-burn checklist will be reviewed by both parties to ensure all actions have been
completed and necessary resources identified are in place.
3. The perimeter shall be walked to ensure the required fire breaks have been made.
4. Weather conditions will be assessed to fall within the following parameters:
a. Relative humidity 30-50%
b. Wind speed 5-10 mph
c. Temperature 40 to 75°F
5. Final notifications will made to Comm. Center and any required traffic control or
monitoring will be activated.
Conducting the Burn:
1. The burn shall be conducted as outlined in the narrative burn plan.
2. As the burn is being conducted, if three or more verified smoke complaints are received
the burn shall be ordered to be ceased and extinguished.
3. The assigned fire inspector or fire company shall verify that there is no visible smoke and
a minimum of a 12 foot fire break on the perimeter of the burn.
Policy 701.00 Page 3
03/O1/15
4. The lead person shall provide a re-check of the burn area at one, two and three hours post
burn. After the final post burn check, the fire department shall be notified at the number
designated on the permit.
Policy 701.00 Page 4
03/O1/15
CITY OF OSHKOSH
Natural Prairie Burnin�Personnel Training Requirements and
Personal Protective Equipment Requirements
1. All personnel involved in conducting the prescribed burn shall have at minimum the following training and
provide documentation of completion:
A. National Wildland Coordinators Group:
a. 5-130
b. 5-190
c. L-180
B. National Incident Management System
a. IS 700
2. The person submitting the burn plan shall have at minimum the following training and provide
documentation of completion:
A. National Wildland Coordinators Group:
a. 5-390
3. The person designated as the lead person conducing the burn operation shall have in addition to the
minimum raining listed above the following training and provide documentation of completion:
A. National Wildland Coordinators Group:
a. 5290
B. National Incident Management System
a. IS-700
b. IS-100
4. Minimum Personal Protective Equipment Required for all personnel participating in burn activities.
A. Hard Hat
B. Eye Protection
C. Flame Retardent Shirt/Pants
D. Leather Gloves
E. Leather Shoes
Appendix A
Policy 701.00 Page 5
03/O1/15
A Prescribed Burn of a Natural Prairie Area Is
Scheduled to Be Conducted Near Your
Property
Location:
During the Week of:
You are being notified as you are within 1,000 feet of the potential downwind area.
The prescribed burning of this area has been approved and a permit is on file with the City of Oshkosh
Fire Department. This prescribed burn is being conducted to promote the establishment and restoration
of native prairie grasses and flowers.
The prescribed burn will be conducted by trained personnel approved by the City of Oshkosh Fire
Department in accardance with an approved plan. The fire will only be allowed under specific weather
conditions and will be conducted during normal business hours Monday through Friday or Saturday
morning of the dates listed above.
The properties immediately adjacent to the burn area will also be notified immediately prior to the burn.
If you have concerns regarding the potential effect on your health or business operations, please contact
the Oshkosh Fire Department at 920-236-5240.
If you have any questions regarding the prairie burn ar how it will be conducted, please contact:
Appendix B
12/21/11
CITY OF OSHKOSH
INSURANCE REQUIREMENTS
III. PROFESSIONAL SERVICES LIABILITY INSURANCE REQUIREMENTS
The Contractor shall not commence work on contract until proof of insurance required has been
provided to the applicable City department before the contract or purchase order is considered for
approval by the City.
It is hereby agreed and understood that the insurance required by the City of Oshkosh is rip maN
coveraqe and that any insurance or self insurance maintained by the City of Oshkosh, its officers,
council members, agents, employees or authorized volunteers will not contribute to a loss. All
insurance shall be in full force prior to commencing work and remain in force until the entire job is
completed and the length of time that is specified, if any, in the contract or listed below whichever is
longer.
1. PROFESSIONAL LIABILITY
A. Limits
(1) $1,000,000 each claim
(2) $1,000,000 annual aggregate
B. Must continue coverage for 2 years after final acceptance for service/job
2. GENERAL LIABILITY COVERAGE
A. Commercial General Liability
(1) $1,000,000 each occurrence limit
(2) $1,000,000 personal liability and advertising injury
(3) $2,000,000 general aggregate
(4) $2,000,000 products—completed operations aggregate
B. Claims made form of coverage is not acceptable.
C. Insurance must include:
(1) Premises and Operations Liability
(2) Contractual Liability
(3) Personallnjury
(4) Explosion, collapse and underground coverage
(5) Products/Completed Operations must be carried for 2 years after acceptance of
completed work
(6) The�eneral aqqrepate must apply separately to this proiect/location
3. BUSINESS AUTOMOBILE COVERAGE
A. $1,000,000 combined single limit for Bodily Injury and Property Damage each accident
B. Must cover liability for Symbol#1 - "Any Auto"—including Owned, Non-Owned and
Hired Automobile Liability.
III - 1
12/21l11
4. WORKERS COMPENSATION AND EMPLOYERS LIABILITY— "If' required by Wisconsin
State Statute or any Workers Compensation Statutes of a different state.
A. Must carry coverage for Statutory Workers Compensation and an Employers Liability
limit of:
(1) $100,000 Each Accident
(2) $500,000 Disease Policy Limit
(3) $100,000 Disease—Each Employee
5. UMBRELLA LIABILITY - If exposure exists, provide coverage at least as broad as the
underlying Commercial General Liability, Watercraft Liability (if required), Automobile Liability
and Employers Liability, with a minimum limit of$2,000,000 each occurrence and $2,000,000
aggregate, and a maximum self-insured retention of$10,000.
6. ADDITIONAL PROVISIONS
A. Acceptabilitv of Insurers - Insurance is to be placed with insurers who have an A.M.
Best rating of no less than A- and a Financial Size Category of no less than Class VI,
and who are authorized as an admitted insurance company in the state of Wisconsin.
B. Additional Insured Requirements — The following must be named as additional
insureds on the General Liability and Business Automobile Liability coverage arising
out of project work...City of Oshkosh, and its officers, council members, agents,
employees and authorized volunteers. On the Commercial General Liability
Policy, the additional insured coverage must include Products — Completed
Operations equivalent to ISO form CG 20 37 for a minimum of 2 years after
acceptance of the work. This does not apply to Professional Liability, Workers
Compensation and Employers Liability.
C. Certificates of Insurance acceptable to the City of Oshkosh shall be submitted prior to
commencement of the work to the applicable City department. These certificates shall
contain a provision that coverage afforded under the policies will not be canceled or
non renewed until at least 30 days' prior written notice has been given to the City Clerk
—City of Oshkosh.
III - 2
'��°`� CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYY)
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BE7WEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR
PRODUCER,AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the
terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate
holder in lieu of such endorsement(s.
PRODUCER CONTACT
Insuronce Agency coniacf NAME:
infortnation,including sireet PHONE Insurance AgenYs .FAX— ----------- -
address and PO Box if contact infortnation. �
applicab/e. (NC No..Ext)._ ..___..__. . {AIC No�:
. ._.. -. -.....___......_.�_..... �_._...._._.________.___.___�_.�_.......____W....._.�.____.
E-MAIL
ADDRESS:
INSURER(S)AFFORDING COVERAGE ` ,.. NAIC k
_... . ___.......
iNSUReR n: ABC Insurance CompanX ' NAIC#
P Y _ __
INSURED /nsured's contacf infortnaLOn, '
including name,address and INSURER B: XYZ IIISUI'BiIC@ CORI an NAIC#
phonenumbec INSURERC: �MN�tlSUf0f1C@C01'T1p8t1�/ - NA�C#
_.. _K1 _ ,g
INSURER D: Insure s musf Aave a minimum A.M.Best ratin ofA-
and a Financia)PeAormance Raling of IR or bener.
INSURER E:
_...... . ..........._...... .._......... . . ,...._........ _........ ....._......
INSURER F: �
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUE� TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE AMY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
__._.......... _ _... _ __....... _... ......
INSR' ADDL<SUBR� POLICY EFF POLICY EXP
�TR� TYPE OP INSURANCE '�. INSR € WVD : POLICY NUMBER � MMIDDIY � MMIDD LIMITS �
�GENERAL LIABILITY � � :
; _ : EACHOCCURRENCE �.$.1,000,000
� ..._. ___._. .._......
DAMAGETO RENTED '
A ��"COMMERCIALGENERALLIABILITY �- � � ❑ GeneralllabiliryPOlicyNumber : Policye%ctiveandexpirationdate pREMISES(Eaoccurrence) $5�,���
❑�CLAIMS-MADE E��OCCUR ; [ „MED EXP(Any one person) $5,000
,__ __ � � _ _ _ ._ _. _._._�_.___
;�'_. ISO FORM CG 20 37 OR E�UIVALENT � ; :PERSONAL 8 ADV INJURY ; $'I,OOO,OOO
,._. �_�.._.__�.._...________�__�......._. �� : :____...._...._____. ._._�..._. �._._��._ .._..___..__
;❑; 'GENERALAGGREGATE ' $2,000,000
�_.—..
_____________._.___ _ __ � ,�_ _______�__.. _..__�.
`GEN'L AGGREGATE LIMIT APPLIES PER � �.PRODUCTS—COMP/OP AGG $2 OOO OOO
�. ,.. � _ : : . ....._.. ..__ ._ _._.._ _..._
;❑pOLICY's�PECT`;❑'LOC � j !
$
iAUTOMOBILE LIABIUTY s :COMBINED SINGLE LIMIT
E : : (Ea accident) � $1 ������
�... .. : ,............... .......... ............
iI�',ANY AUTO I � E � ' Auto Liability Policy Number � Policy effective and expiration date ;BODILY INJURY(Per personj : $mm^^m...........N______..._..
.�_.. __._.__ ____.__._.. ________�_
B �❑;ALLOWNED �� SCHEDULED ( ,
AUTOS AUTOS ( ; BODILY�NJURY(Per accident) $
( _, _____.__._�__ _ .--
� HIREDAUTOS ; NON-0WNED � ; ; ; PROPERTYDAMAGE
�❑ ❑ AUTOS ; j ; (Per acudent) $
,�� f�j � _ _ ______ _ ___ .$_.. .______
i�?UMBRELLA LIAB`�;�CCUR � ( � � ; EACH OCCURRENCE $Z,OOO,OOO
� ' _.__. ..........
A I�EXCESSLIAB :❑�. CLAIMS-MADE � �..UmbrellaLiabilityPOlicyNumber � Policyeflectiveandexpirationdate �AGGREGATE _ $.2,���,���
f ............,.. . �.... � ........ . _.......- .
...._. ......__._._. .$ _.
���DED ��RETENTION$$IO,OOO �
C �WORKERS COMPENSATION � ; � �; �ORV�LI ITS� �ER �I
AND EMPLOYERS'LIABILITY
ANY PROPRIETOR/PARTNERlEXECUTIVE € ' ' ' ` ` .
�OFFICE/MEMBER EXCLUDED9 Y�N '_ t ; Workers Compensation Policy �,, Policyeffective and axpiratan date :E.L.EACH ACCIDENT �. $100,000
�(Mandatoryin NH) N f Num6er ��.� � .___ __�._...___._._
1.If yes,descnbe under � € i iE,L.DISEASE EA EMPLOYEE $100,000
_..... _
i DESCRIPTION OF OPERATIONS below � �:E.L.DISEASE—POLICY LIMIT � $SOO,OOO
A �PROFESSIONAL LIABILITY � I � ; ; ;$1,000,000 EACH CLAIIvI
; ProfessronalLiabiliryPOlicy � Policyeffecfiveandexpiraliondafe ;$1,000,OOOANNUALAGGREGATE
Numher
DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(Att�ach ACORD 101,Additional Remarks Schedule,if more space is required)
Additional Insureds on the Commercial General Liability and Automobile Liability arising out of project work shall be City of Oshkosh,and its
o�cers,council members,agents,employees and authorized volunteers.
Certificates of Insurance acceptable to the City of Oshkosh shall be submitted prior to commencement of the work to the applicable City
department. These certificates shall contain a provision that coverage afforded under the policies will not be canceled or non renewed until at
least 30 days'prior written notice has been given to the City Clerk—City of Oshkosh.
CERTIFICATE HOLDER CANCELLATION
Clty Of OShkOSh,Attn:City Cierk Insurance Standard 111 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
215 Church Avenue SAMPLE CERT/FICATE TME EXPIRATION DATE,THEREOF,NOTICE WILI BE DELIVERED IN
PO BOX 1130 ACCORDANCE WITH THE POLICY PROVISIONS.
Oshkosh,WI 54903-7130 P�ease indicate somewhere on this
certificate,the contract or project# AUTHORIZED REPRESENTATNE
this certificate is for.
O 1988-2010 ACORD CORPORATION. All rights reserved.
ACORD 25(2010l05) The ACORD name and logo are registered marks of ACORD
CITY OF OSHKOSH FIRE DEPARTMENT
� � Fire Prevention Division
� � � ��� 101 Court Street, Oshkosh WI 54901
Phone: 920 236-5241 Fax 920 236-5295
NATURAL PRAIRIE BURN APPLICATION
Applicant Information Owner's Information
Name: Name:
Business: Business:
Address: Address:
City/State/Zip: City/State/Zip:
Telephone: Telephone:
General RecLuirements of Fire Deparhnent Licenses:
1) All permit applications shall be submitted 30 days prior to commencing the prescribed activities..
2.) Application can be made at the City of Oshkosh Fire Department, 101 Court St,Oshkosh WI 54901.
4) Permit fees are$108.00 per burn.
5) Permit fees are payable to the City of Oshkosh.
6) A permit is not transferable,and any change in equipment,ownership,use or occupancy of premises shall require a new permit.
7) An inspection will be required before the issuance of a permit.
8) Applications shall be acted upon within seven(7)business days.
11) Complete the instructions on the reverse side of this form.
By completing and siening this permit application you acknowledge and agree to comply with City of Oshkosh,Ordinance Chapter
, Wisconsin Administrative Codes and the International Fire Code.
Applicant Signature: Date:
Title or position:
-------------------------------------------------------------------------------------------------------------------------------------------�
This portion to be completed by The City of Oshkosh Fire Department
The above applicant has been granted permission to conduct processes as prescribed in this application. Permission is contingent
upon compliance with all applicable codes and standards.
Fire Department Signature Date
Title
Appendix D Page 1 of 2
Natural Prairie Burn Information
Location of Burn
Address:
Site Name:
Date Ran�e
To
(This burn permit is only good for one burn during the time period indicated above)
Onsite Contact
Contact Name: Phone Number:
Contact Name: Phone Number:
Submittal Requirements
The following items shall be submitted along with the City of Oshkosh Fire Dept's Burning Permit application and$108.00 fee.
1. Proof of ownership,or written permission of property owner,or contract to perform burn signed by property owner.Proof
of ownership could be tax bill, deed, or mortgage.
2. Site Plan(can be hand drawn).
a.Property lines.
b.Fire breaks.
c.Area to be burned.
d.Any buildings within 50 feet.
e. Location of any right of way within 25 feet of area to be burned.
f. If location is in close proximity to major highways include placement of signage to alert motorists of the fire and
smoke.
3. A burn plan prepared by a person trained to s-390 level in accordance with the National Wildland Coordination Group to
include.
b.Names of persons assisting with burns.
c.Method of starting fire.
d.How will fire spread be controlled?(fire breaks,back fire,etc)
e.Description of vegetation to be burned.
1)Vegetation to be burned cannot include piles of leaves,yard waste,brush and trash.
f. Signage for major highways.
g. . A plan for notifying the neighbors immediately adjacent to the burn and potential downwind neighbors within 1,000 feet
downwind of the burn.(see attached example)
h. List of who was notified shall be availble on day of the burn.
i. Contact name(s)and on-site phone numbers(cellular phones).
5. Proof of Training
6. A list of fire control resources required to be present on the day of the burn which at minimum will include(additional
personnel and resources may be required at the discretion of the Oshkosh Fire Department):
Appendix D Page 2 of 2