Permit Request • CampusOptics

Any fire outside of metal fire pits or grills specifically designed to contain flames requires completion and issuance of a Controlled Burn Permit. This form must be submitted no later than five (5) business days prior to the event. All actions indicated on the safety checklist must be completed before burning, and an inspection by the Office of Emergency Management may be required.

You may contact the Office of Emergency Management for any questions at (870) 972-2862 or Ronnie Gilley at rgilley@AState.edu.

Requester

Email Address* Required

Phone Number* Required

First Name* Required

Last Name* Required

Permit Date & Time

Start Date* Required

Start Time* Required

Expiration Date* Required

Expiration Time* Required

Location

Campus, Building, or Outdoor Area* Required

Additional Location Details

Controlled Fire Emergency Action Plan

Specific Location of Controlled Fire* Required

Purpose of Controlled Fire* Required

Name of Individuals Assigned to Fire Watch* Required

Material Used for Fuel* Required

Burn Pile Size* Required

Distance from Nearest Structure* Required

Distance from Nearest Property Line* Required

Fire Attendance* Required

Fire Suppression Availability* Required

A-State Staff/Faculty Representative* Required

Date* Required

Phone number* Required

Add Supporting Documents

Add files to upload as supporting documentation along with your permit request.

Files

Requester

Permit Date & Time

Location

Controlled Fire Emergency Action Plan More information

Add Supporting Documents

Controlled Fire Emergency Action Plan