Name of Permit Applicant or Responsible Party:*

Organization or Business (if applicable):

Mailing Address:*

City:*

State: *

Select a StateAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMassachusettsMarylandMichiganMinnesotaMississippiMissouriMontanaNorth CarolinaNorth DakotaNebraskaNevada New Hampshire New JerseyNew MexicoNew YorkOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVirginiaVermontWashingtonWest VirginiaWisconsinWyomingWashington D.C.

Zip: *

Phone: *

Email Address*

Exact Burn Location: *

Purpose of Burn:*

Type and Quantity of Materials Being Burned: *

The following equipment will be readily available at all times during and after the burn: *

Proposed Date of Burn: *

(NOTE: Burn permit is only valid for the date(s) indicated)

-----------------------------------------------------------------------------------------------------------------------------------
IMPORTANT INFORMATION

-Burn permits must be applied for at least 48 hours prior to proposed burn.

-Permit Applicant MUST notify Taos Central Dispatch (575-758-2216 or 2217) by telephone immediately prior to the burn being ignited on the approved day(s). Taos Central Dispatch may deny this permit if the wind speeds are forecasted to be above TEN miles per hour or if FIRE resources are otherwise committed. Taos County Fire Chief or District Fire Chief will notify Taos Dispatch (USFS and BLM) if burning is cancelled for the day.

-Burning can start 30 minutes after sunrise and end 30 minutes before sunset. At sunset the burn must be completely extinguished. .

-If wind speeds reach 10 MPH, Applicant must extinguish the burn.

-Permit Applicant shall understand and comply with Taos County Ordinance 2018-03, NMAC20.2.60 and 20.2.65 at all times.
Copies of these documents are available upon request.

-Permit Applicant SHALL NOT burn construction materials, rubber, plastics, petroleum products, or other synthetic materials,
nor will Permit Applicant burn any form of household waste as defined by Title 20, Chapter 2, Part 60 NMAC of the Air
Quality Control Act.

-The Permit Applicant shall not burn any material within 300 feet of any residence. If this is not possible, Permit Applicant
must notify all residents within a 300 foot radius of the proposed burn at least 72 hours in advance.

-The permit applicant shall not burn in the vicinity of any structure, vehicle, fuel tank, live vegetation, electrical wires, or
watercourse (except dry Acequia’s).?The Permit Applicant shall allow inspection of the burn site listed above before, during, and after the burn if so requested
by any agency.

-The Permit Applicant agrees to pay all costs associated with the containment and extinguishment of any fire that escapes
the designated burn area listed above.

-The Permit Applicant agrees to pay the costs of any damages associated with this burn should the burn escape the control
of the Permit Applicant.

-The Permit Applicant shall provide an alternate method of removing material to be burned within 72 hours in the event the
permit is canceled or revoked.

-The Permit Applicant shall possess a copy of this permit at all times during the burn and produce it for any official who
requests to view this permit.

This burn will be attended at all times by the Permit Applicant and:

--------------------------------------------------------------------------------------------------------------------------------------------
Permit applicant acknowledges the danger of uncontrolled or out-of-control fire may cause, including but not limited to the loss of life, personal injury, and damage and/or destruction of real and/or personal property. As consideration for issuances of this burn permit, Permit Applicant hereby assumes and accepts any and all responsibility for any and all consequences from the burn, the start of which is allow by this permit. Permit Applicant acknowledges sole and full responsibility in exercising utmost care and sound judgment before starting any fire. Permit Applicant agrees to reimburse Taos County for reasonable costs to suppress any fire that escapes the control of the Permit Applicant. Costs are to be determined using criteria established annually by the New Mexico Energy, Minerals, and Natural Resources Department, Forestry Division, per Taos County Ordinance 2018-03, Section 8. Permit Applicant understands that Taos County reserves the right to suspend or cancel this burn permit at any time in order to protect the public interest.

As further consideration for issuance of this burn permit, Permit Applicant hereby agrees, indemnifies, and hold Taos County
harmless from and against any and all claims, actions, liability, damages, judgments, costs, attorney’s fees, and expenses of any nature, occasioned or incurred by Taos County, any recognized Fire District, Carson National Forest Service, Bureau of Land Management, New Mexico State Forestry Division, or other entity, as a result of the fire started by Permit Applicant, without which fire Taos County would not be involved in the issuance of a burn permit.

I have read and agree to adhere to the requirements as stated above.*

Permit Applicant/Responsible Party Signature:*

---------------------------------------------------------------------------------------------------------------------------------------------------------------

Signature indicating approval of one of the following makes this permit valid:

Taos County District Fire Chief or Designee:___________________________________________________________

Taos County Fire Chief or Designee:______________________________________________________________________________________________

Issued Date: __________________________________

Valid Dates: ___________________________________