St. Martin's by the Bay

Application for Controlled Burning Permit

One West Market Street, Room 1306 Government Center, Snow Hill, MD 21863, 410-632-1220 Property Owner: _St. Martins By The Bay H.O.A, Mailing Address: P.O. Box 1404 Berlin MD 21811 Phone: 443-497-0807 Applicant:_Mike Shutt (Treasurer) Phone:_ 443-497-0807 Mailing Address: 11311 Marina Drive #50 Berlin MD 21811

• provide a sketch of the property or aerial photo indicating the location of the proposed burn site(s).***

Location of Property: Purpose of proposed burn: Despose of Brush and downed tree limbs etc. from community. Size of Property (acres) ....28 Acres. Distance to: Nearest occupied dwelling Public road Nearest Property line 300 140 120 _ Feet Minimum 1500 feet required to Feet _Feet dwellings and roads (see #10 on page 2 if distances cannot be met) Applications received without appropriate distances or requirements of #10 will be returned as incomplete By signing below 1 understand that all conditions of this permit listed on page 2 of this permit must be complied with. At no time may dangerous, hazardous, or nuisance conditions be present on the burn site or any neighboring properties. All applicants must contact the Worcester County Emergency Services (410)632-1311 prior to the start of any burning. This permit does not exempt the applicant or property owner from any fines or legal actions from other governmental agencies or civil suits, should any laws be broken or harm inflicted to neighboring properties or occupants. Owners Signature Date 183/14 Applicants Signature Date Please make check payable to Worcester County Cal tam Worcester County Approving Authority 10/3/14 For Office Use Only Citizens and Government Working Together