<form-template> <fields> <field type="text" subtype="text" required="true" label="Name" class="form-control text-input" name="text-1656971112964"></field> <field type="text" subtype="text" required="true" label="Cell Phone number" class="form-control text-input" name="text-1656971126084"></field> <field type="text" subtype="text" required="true" label="Alternate Phone Number " class="form-control text-input" name="text-1656971147358"></field> <field type="text" subtype="text" label="Email " class="form-control text-input" name="text-1656971169765"></field> <field type="select" required="true" label="I intend to set fire and burn " class="form-control select" name="select-1656971198701"> <option value="option-1">Grass/Slough</option> <option value="option-2">Stubble/Crop</option> <option>Bush </option> <option selected="true">Other </option> </field> <field type="text" subtype="text" label="If Other please state what" class="form-control text-input" name="text-1656971396496"></field> <field type="text" subtype="text" required="true" label="legal description" class="form-control text-input" name="text-1656971429094"></field> <field type="text" subtype="text" label="Legal description" class="form-control text-input" name="text-1656971451886"></field> <field type="text" subtype="text" label="legal description " class="form-control text-input" name="text-1656971528846"></field> <field type="date" required="true" label="Max of two weeks starting on " class="form-control calendar" name="date-1656971666777"></field> <field type="date" required="true" label="two weeks ending on " class="form-control calendar" name="date-1656971712969"></field> <field type="checkbox-group" required="true" label="I will adhere to the conditions and provisions of the wild fire act and municipal by-laws including " class="checkbox-group" name="checkbox-group-1656971781283"> <option value="option-1" selected="true">Prior to filling out a CRFD Burn Permit, contact the Province of Manitoba Crop Residue Burning Authorization if burning between April 1st and November 15th to receive their authorization. Call 204-745-5646</option> <option value="option-2">Monitor and keep fire under control at all times </option> <option>Bear responsibility for all property damage which may result from burning done under this permit </option> </field> <field type="text" subtype="text" required="true" label="I agree to all mentioned above (yes or no)" description="Write Yes or No" class="form-control text-input" name="text-1658942183882"></field> <field type="paragraph" subtype="p" label="All permits will be to forwarded the fire chief, who will contact you with any questions or concerns. All permits can be assumed approved unless otherwise communicated by the Fire Chief *If you expect your fire to be substantial (will be seen from a distance), please contact the Fire Chief via text at 204-825-7804 once you have submitted your permit online to expedite the process " class="paragraph"></field> </fields> </form-template> Submit Submitting...