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2. First & Last Name*
4. Address*
6. City*
7. State*
8. Zip*
10. Home Phone*
11. Daytime Phone
12. Cell Phone
14. Email Address*
16. Do you plan to burn over 20 acres for range or pasture management?*

    1. Yes
    2. No
18. Please estimate how many acres you plan to burn in 2022.*
20. Do you plan to burn within 1/2 mile of Manhattan city limits?*

    1. Yes
    2. No
22. If burning within a 1/2 mile of Manhattan city limits, what is the nearest address?
24. Is this a commercial operation or on commercially zoned property? *

    1. Yes
    2. No

    (For commercial burning, KDHE permit required .pdf)

26. If yes, what is the KDHE permit #?
28. I understand that I have the sole responsibility for supervision and control of any fire I start and this permit does not relieve me or the people assisting me from burning in a safe manner. I understand that I may be held liable for damage to the property of another caused by the burning.
30. I agree to comply with Riley County resolution #092399-32, the Kansas Administration Regulations 28-19-647 and 28-19-648, and or any amendments to such. *

    1. Yes
    2. No
32. Signed (Enter your name):*
34. We plan to send notices about burning restrictions due to conditions using the Everbridge emergency notification system. We recommend that everyone who has a burn permit sign up for this FREE service. Go to www.rileycountyks.gov On the left hand side of the screen click on emergency notifications. Click on Sign Up to create an account. Or if you have already created an account click on login. Complete the required information. Sign up for Riley County Prescribed Burning.
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36. 1. Receive an email copy of this form.
37. Email address

    This field is not part of the form submission.

38. Submit

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