21.10.460 Field registration.
Yurok Tribe Application for Field Registration |
For office use only Tracking Number: 03-FR -____________ Date Received:________________ Payment Received: ______________ Permit Approved:_______________ Permit Mailed:_________________ Comment Op/Cl:_______________ |
Applicant Name: _______________________ |
Date:______________________ |
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Mailing Address:____________________________________________________________ |
Fields applied for: |
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---|---|---|---|
Field No. |
APN |
Location (T/R/S) |
Acres |
Fees Due: |
$XX.00 per acre x _____________ |
Acres: |
$ |
IMPORTANT: Your application for Field Registration does NOT constitute permission to burn! You will receive a copy of your Permit through the mail within two weeks of receipt of your completed application and fees. Once you receive your Permit, you are expected to comply with the provisions of the Air Quality Ordinance and the Tribal Smoke Management Plan. |
I agree to comply with the Tribal Air Quality Ordinance and Smoke Management Plan. |
|
(applicant signature) |
(date) |
DETAILED INFORMATION SHEET |
Copy as necessary – Fill out one sheet per section |
Please locate and identify in the Section below: Fields to be burned, access roads, highways, houses, other sensitive areas or hazards, and include arrows to sensitive areas outside of this section. When more than one field is shown, label each field using the field number from page 1. |
T: ____________________ R:________________________ Section:___________________ |
Field Number(s):_________________________ |
Primary Purpose of Burn:______________________________________________ |
Special Burn Considerations:____________________________________________ |
_______________________________________________________________________ |
_______________________________________________________________________ |
_______________________________________________________________________ |
Alternatives Analysis: |
Attach an evaluation of alternatives considered for burning activities. |
Emissions Reduction: |
Attach a description of emissions control measures which will be taken in this project. |
Certification: |
Attach proof of certification congruent with YTC 21.10.310 of the Smoke Management Plan. |
Monitoring: |
If required by the Smoke Management Plan, attach a detailed visual monitoring plan. |