Online Form - Fire Permit Request

The following supporting information, along with a map of the proposed area to be burnt, is required before a Fire Permit can be issued. Fire permit requests must be submitted 48 hours prior to the requested date. 

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You have the ability to save this form and complete it at a later date. An email will be generated and sent to the specified address.

Note: Incomplete forms are kept for a period of 2 day(s) , after this time the system will automatically delete your response.

Applicant Details

Postal Address
Residential Address

Preliminary Information

Maximum period - 28 days


Burn Objectives

Tick as appropriate

Please select Burn Objectives *

Fire Suppression Equipment

Please ensure you enter quantity and water capacity/notes on the equipment you will be using.


Personnel

Personnel required - minimum of 3


Notification

Below are the contacts of Stakeholders and the method of notification required:
Shire of Wyndham East Kimberley | Rangers | Telephone: 08 9168 4166
DFES | Regional Ops Centre | 1800 198 140

Please provide below contact of neighbouring properties and their preferred notification method.


Burning Prescriptions


Site Risks

Powerlines
Buildings
Movement of aircraft
Adjacent public thoroughfares
Others (please specify)

Containment / Firebreak / Wind

Please provide as much information as possible regarding Area, Type (Slashed, Ploughed, Mineral Earth) and size (meters)


Map

PLEASE ATTACH A DETAILED MAP OF YOUR PROPOSED BURN BELOW.
A detailed map should include the following:
- Aerial image with boundaries/breaks clearly outlined
- GPS co-ordinates specified
- Adjacent roads highlighted


Conditions

Please note that this consent is granted with the following conditions:

1) Permit valid for the purposes, dates and areas in this application only
2) No responsibility will be accepted by the Shire for any damage caused
3) Consent maybe withdrawn by the Shire at any time
4) The permit holder indemnifies the Shire against any claim for personal injury, damage or any other loss arising howsoever from said fire use


 
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