<form-template> <fields> <field type="header" subtype="h3" label="MUNICIPALITY OF KILLARNEY TURTLE-MOUNTAIN - PERMIT TO BURN" class="header"></field> <field type="textarea" required="true" label="NAME" class="form-control text-area" name="textarea-1704306855947"></field> <field type="textarea" required="true" label="PHONE NUMBER" class="form-control text-area" name="textarea-1704306872130"></field> <field type="textarea" required="true" label="EMAIL ADDRESS" description="WE WILL EMAIL YOU A SIGNED COPY OF YOUR BURN PERMIT TO THE EMAIL INDICATED" class="form-control text-area" name="textarea-1704307889121"></field> <field type="select" required="true" label="WHAT ARE YOU BURNING?" class="form-control select" name="select-1704386237270" multiple="true"> <option selected="true">STUBBLE </option> <option>GRASS</option> <option>SCRUB</option> <option>OTHER</option> </field> <field type="textarea" label="IF SELECTED OTHER, PLEASE INDICATE WHAT YOU ARE BURNING" class="form-control text-area" name="textarea-1704307024835"></field> <field type="date" label="START DATE" description="SELECT THE DAY YOU ARE PLANNING TO START BURNING " class="form-control calendar" name="date-1704307069938"></field> <field type="date" required="true" label="BURN PERMITS ARE ONLY AUTHORIZED FOR 1 WEEK PERIODS. PLEASE SELECT THE DATE THAT IS 7 DAYS AFTER YOUR START DATE." description="EXAMPLE: IF YOU START YOUR BURN SEPTEMBER 7, PLEASE SELECT SEPTEMBER 14 " class="form-control calendar" name="date-1704307108058"></field> <field type="select" required="true" label="PLEASE CHECK OFF EACH LINE TO INDICATE ACKNOWLEDGEMENT " class="form-control select" name="select-1704386327036" multiple="true"> <option selected="true">PLEASE CHECK OFF EACH LINE TO INDICATE ACKNOWLEDGEMENT </option> <option>TO BEAR THE RESPONSIBILITY FOR ALL PROPERTY DAMAGE THAT MAY OCCUR</option> <option>TO FIREGAURD THE AREA AS REQUIRED UNDER THE TERMS OF THE "FIRES PREVENTION AND EMERGENCY RESPONSE ACT "</option> <option>NO FIRE TO BE SET AND LEFT UNATTENDED </option> <option>MULTIPLE FIRES ARE NOT TO BE SET ON MUTILPLES SITES AT THE SAME TIME </option> <option>FORM MUST BE KEPT WITH YOU WHILE BURNING </option> </field> <field type="text" subtype="text" required="true" label="I UNDERSTAND THE CONIDTIONS UNDER WHICH THIS PERMIT IS ISSUED AND AGREE TO ABIDE THEREBY" description="SIGNATURE " class="form-control text-input" name="text-1704308159350"></field> <field type="header" subtype="h3" label="BURN PERMITS CAN BE REVOKED AT ANY TIME AT THE DISCRETION OF THE MUNICIPALITY OF KILLARNEY TURTLE-MOUNTAIN" class="header"></field> <field type="checkbox" label="Checkbox" class="checkbox" name="checkbox-1704386325386"></field> </fields> </form-template> Submit Submitting...
