2. 

4. Chambers County Fire Marshal
   Controlled Burn Courtesy Notification Form

   **THIS IS NOT A PERMIT**

6. Person Conducting Burn*
7. Phone Number*
9. Landowner (if different)
10. Landowner Phone Number (if different)
12. Physical Address/Location of Burn Site*
13. City, State, ZIP*
15. Acres to be Burned*
16. Nearest Structure*
17. Distance to Structure*
19. Have neighboring landowners been notified?*
    -- Select One --YesNo
20. Burn Date/Time*
    Burn Date/Time

    Burn Date/Time
22. Please describe the steps you will use to control and prevent the fire from becoming uncontrolled:*
24. Outdoor burning must be conducted in accordance with state law and TCEQ rules at all times:
    1. Burning must be monitored and controlled onsite at all times;
    2. Burning must be conducted downwind of or at least 300 feet (90 meters) from any structure containing sensitive receptors located on adjacent properties unless prior written approval is obtained from the adjacent occupant with possessory control (houses, neighborhoods, livestock, etc.);
    3. Smoke may not cause a nuisance for adjacent homes or properties;
    4. Burning may only be conducted during daylight hours;
    5. Smoke may not impede a roadway or airstrip;
    6. Only vegetation produced on site may be burned (no outside vegetation may be brought in, and no items other than vegetative materials may be burned);
    7. Prohibited materials may not be burned (tires, insulation, shingles, plastics, etc.).

    Texas Administrative Code Rule §111.219 (PDF) - General Requirements for Allowable Outdoor Burning

26. Electronic Signature Agreement*

    By checking the "I agree" box below, you agree and acknowledge that 1) this is not an application for a burn permit and 2) any burning will be done in accordance with state law and rules set by TCEQ.

    1. I agree.
28. Electronic Signature*

30. For more information, please visit the Chambers County Fire Marshal's Office webpage.

Leave This Blank:


34. 1. Receive an email copy of this form.
35. Email address

    This field is not part of the form submission.

36. Submit

* indicates a required field