Permit number _________
New or Renewal
Address where burning will take place
Location on lot where burning will take place
I understand that the permit is issued on the basis that the above conditions are met and in accordance to Shelby Town Ordinance 2.01
By typing your name below, You agree that this is valid as your signature.
Signature of Applicant
This permit will not expire as long as the Fire Ring stays at the approved location and the Owner of the property does not change.