Burn Permit Application

City of Dickson Fire Department

Application for Burn Permit
Name

First NameLast Name
Contractors' Business Name
Property Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Burn Permit Policies and Procedures
I have read and understand the City Ordinance on open burning and agree to comply with the ordinance. I also Understand that the City of Dickson, it's officials, employees and/or agents do not assume any responsibility or liability in the burning by issuance of this permit:
Signature
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit year
Please call 615-446-6331 on the day you wish to burn to receive your permit number.
Should be Empty:

City of Dickson Fire Department