Burn Ban Extension Request Form
Request an extension to an existing burn ban. Please complete all required fields to help us process your request efficiently.
Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Organization or Agency (if applicable)
Location of Burn Ban (Address or Area)
*
Current Burn Ban Reference Number
*
Reason for Extension Request
*
Requested Extension End Date
*
 -
Month
 -
Day
Year
Date
Supporting Documentation (if any)
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