Country Fire Authority Act 1958

COUNTRY FIRE AUTHORITY ACT 1958

APPLICATION FOR SCHEDULE 13 PERMIT

PERMIT TO BURN BY A PRIVATE PERSON

This is an application for a permit to use fire during a Fire Danger Period. If issued, the permit does not allow the permit holder to use fire on a day of Total Fire Ban.

Note: This application is only relevant to land within the area defined as the Country Area of Victoria and is not applicable in the Metropolitan Fire District or within any State forest, national park, on protected public land or within any fire protected area under the Forest Act 1958.

All sections, check boxes, and signatories must be completed. Incomplete application forms will not be assessed.

To: The Municipal Fire Prevention Officer

The applicant hereby applies for a Schedule 13 permit under Section 38 of the Country Fire Authority Act 1958. The applicant supplies the following information in support of the application.

APPLICANT DETAILS
Applicant name
The person performing the burning operation (ignition and control) to which the permit relates.
Note: Application must be signed by the applicant and land owner/manager if different from the applicant. / Please select title: Mr.Mrs.Ms.Miss
Applicant relationship to the land (or land owner) for which permit is sought
E.g. owner, tenant, contractor, etc.
Corporation/Company name (if applicable)
Address of applicant
(and Corporation/Company address where applicable and different to applicant address)
Street Address & Property Name
Town/Suburb
Postcode
(Must be a physical street address, not PO Box)
Email address (if available)
Telephone
Must be 24 hour availability
BURN DETAILS
Purpose statement
Describe why the use of fire in the open air during the Fire Danger Period is necessary.
Application will only be considered for essential purposes. E.g. fine fuel - stubble management – weed control - in preparation for cropping.
Material to be burned
Tick relevant box/s / Grass
Stubble / Weeds
Other (specify)
Period of time for which permit is sought
Specific commencing and ending date.
Provide maps (if possible) showing specific area/s including the following detail;
-  Property boundary
-  Areas/s to be burnt (size in Ha)
-  Boundary fire breaks / -  Water points
-  Neighbouring property assets
-  Access roads (internal/external)
Specific address, land parcel identifier (recorded on rates notice), or description and location of burn area*. List below. / Type of material
E.g. wheat stubble, canola stubble, etc. / Area (Ha)
*If multiple burn areas/types, list individually.
If there is not enough room, please include a list with this application.
Land description
E.g. flat plains, gently undulating, neighbouring bushland.
APPLICANT ACKNOWLEDGMENTS
The applicant acknowledges that: / Please confirm acceptance by initialling each box
·  conditions and restrictions will apply if a permit is granted. The applicant agrees to abide by these conditions and restrictions and is aware that any permit granted may be revoked.
·  failure to comply with each of the conditions and restrictions contained in any permit issued is an offence under section 38(3) of the Country Fire Authority Act 1958 and penalties for non-compliance will apply
·  compliance with the permit conditions will not of itself relieve the holder of the permit from liability (civil or criminal) for any damage sustained by another person as a result of any fire lit by the holder of the permit, under section 38(4) of the Country Fire Authority Act 1958.
·  if a permit is issued, the permit will only apply to the specific address or description and location of land to which the permit relates.
·  a permit to use fire in the open air during a Fire Danger Period does not allow the permit holder to use fire on a day of Total Fire Ban.
·  the [insert municipal council] will assess this application, and may determine not to issue a permit. In some instances the application may be referred to the District CFA for assessment.
I declare that I am the applicant and all the information in this application is true and correct; and that the above acknowledgements are understood. I agree to comply with all the conditions and restrictions applied to any permit issued to which this application relates.
Signature ………………………………………….……… Date
Applicant Identification (e.g. Driver’s Licence number)
Expiry Date Issuing Agency
Land owner/manager details (only applicable if applicant is not the owner or land manager)
I, the owner of the above mentioned land, provide approval for the applicant to undertake any and all approved actions on my land to which this application relates if a Schedule 13 permit is issued.
Name
Signature…………..…………………………………………….
Date
Telephone
Email
Note: Where the land owner/manager details and signature cannot be sourced due to owner absence, applicant must obtain written endorsed confirmation of approval to accompany application on submission.

This application may be lodged:

CFA District 20
56 Fitzroy Street KERANG, 3579, VIC

Email:

Fax: 03 5452 2531

Queries? Phone: 03 5450 3406

Conditions for Permit to Burn within Gannawarra Shire

·  Permits to be issued for commercial business progression only (stubbles, grasses, diseased stock)

·  Light up time of no earlier than 1700 hrs

·  Grass and stubble only

·  Planned burn area no larger than 30 hectares (irrigation areas) or 100 hectares (Broad Acre areas West of the Kerang Boort road)

·  Maximum 100 hectares per individual burn at any one time

·  1x mobile 2000 litre water cart with operational pump, firefighting hoses per 50 hectares to be burnt. Pump capacity to be sufficient to adequately extinguish fire- not less than 40 litres per minute.

·  2 able bodied adults in attendance at all times the burn is alight

·  Mineral earth fire break of not less the 3 metres in width

·  Minimum 2 responsible and capable adults in attendance at all times in the paddock. CFA appliances not to be included in these totals.

·  Demonstrate mobile phone capacity to call 000 in area to be burnt, or a common communications plan of UHF radio back to a manned base that has landline facility to call 000.

Notifications

·  Emergency Services Telecommunications Authority

Ph: 1800 668 511 - within 2 hrs prior to ignition

·  All contiguous neighbours must be notified.

·  Officer in Charge of local Fire Brigade must be contacted by telephone between 2 and 24 hours prior to ignition

These along with other standard conditions on the permit must be adhered to.

PERMITS WILL NOT BE ISSUED ON PUBLIC HOLIDAYS

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2017.03.15 Schedule 13 application form