Fillable Burn Permit Form Use this form to apply for a Burn Permit within the Municipality of Louise. <form-template> <fields> <field type="header" subtype="h1" label="Municipality of Louise " class="header"></field> <field type="header" subtype="h3" label="fina@louisemb.com 204-873-2591" class="header"></field> <field type="header" subtype="h1" label="Burn Permit" class="header"></field> <field type="textarea" label="Burn permit valid for two weeks only" class="form-control text-area" name="textarea-1608219768733" value="The permit is not approved until the Municipality of Louise office contacts them and confirms. "></field> <field type="text" subtype="text" required="true" label="Name" class="form-control text-input" name="text-1608148674455"></field> <field type="text" subtype="text" required="true" label="Phone Number" class="form-control text-input" name="text-1608149417850"></field> <field type="text" subtype="text" label="Email" class="form-control text-input" name="text-1611169560704"></field> <field type="date" required="true" label="Start Date of Burn" description="Remember your permit, once approved will be valid for two weeks only." class="form-control calendar" name="date-1608234472228"></field> <field type="date" required="true" label="End date of burn" class="form-control calendar" name="date-1632491531145"></field> <field type="textarea" required="true" label="Burn Locations " class="form-control text-area" name="textarea-1608148703663"></field> <field type="checkbox-group" required="true" label="What is being burned" class="checkbox-group" name="checkbox-group-1608148805120" enable-other="true" other="true"> <option value="Grass">Grass</option> <option value="Stubble/Crop">Stubble/ crop</option> <option value="Bush">Bush</option> <option value="Tree's ">Tree's </option> <option value="Municipal Ditch">Municipal Ditch</option> <option value="Structure">Structure</option> </field> <field type="textarea" label="Please explain &quot;Other&quot; if that was what you selected above" class="form-control text-area" name="textarea-1614178761251"></field> <field type="checkbox" required="true" label="Declaration of Applicant: I understand the conditions under which this permit is issued and agree to abide " class="checkbox" name="checkbox-1608148946530"></field> <field type="checkbox" required="true" label=" 1. Keep fire under control at all times " class="checkbox" name="checkbox-1608305983745" value="1. Keep fire under control at all times "></field> <field type="checkbox" required="true" label=" 2. Bear responsibility for all property damage which may result from burning done under this permit " class="checkbox" name="checkbox-1608221461075" value="2. Bear responsibility for all property damage which may result from burning done under this permit "></field> <field type="checkbox" required="true" label=" 3. To fireguard the area as required under the terms of the Wildfires Act " class="checkbox" name="checkbox-1608221596834" value="3. To fireguard the area as required under the terms of the Wildfires Act "></field> <field type="checkbox" required="true" label=" 4. Fire is surrounded by a minimum six-meter-wide strip of land free of inflammable material " class="checkbox" name="checkbox-1608221624866" value=" 4. Fire is surrounded by a minimum six-meter-wide strip of land free of inflammable material "></field> <field type="checkbox" required="true" label="5. To burn during daylight hours only and in accordance with the Province of Manitoba Crop Residue Burning Authorization (April 1st and November 15th) Enquiries 1-800-465-1233 " class="checkbox" name="checkbox-1608221687342" value="5. To burn during daylight hours only and in accordance with the Province of Manitoba Crop Residue Burning Authorization (April 1st and November 15th) Enquiries 1-800-465-1233 "></field> <field type="checkbox" required="true" label=" 6. No fire to be lit with winds over 30 km/hr " class="checkbox" name="checkbox-1608221715307" value="6. No fire to be lit with winds over 30km/hr"></field> <field type="checkbox" label="7. &quot;structure&quot; I have applied for a SCPD demolition permit" class="checkbox" name="checkbox-1616089897756" value="7. &quot;structure&quot; I have applied for a SCPD demolition permit"></field> <field type="date" label="Date Field" class="form-control calendar" name="date-1632491514543"></field> <field type="date" label="Date Field" class="form-control calendar" name="date-1632491523935"></field> </fields> </form-template> Submit Submitting...
