Summit Fire & Medical District

Variance Request

Ordinance Variance Request Form

Required for any activity involving fire that is currently prohibited under the current fire state. Once submitted, please contact Summit Fire and Medical District Monday through Friday 8 a.m. to 5 p.m. at 928-526-9537 to inform Administration that you have submitted a request for a Variance. If your request requires additional information or if approved, a Summit Fire and Medical District Battalion Chief will contact you.

(If Applicable)
This request MUST be submitted 4 days, minimum, prior to day of work/variance activity.
Street address, city, and zip code or GPS coordinates.
Please describe what activity/work will be done with details that support your request for a variance.
I have read Coconino County Ordinance 2022-04 and understand the rules, requirements and actions expected of me and my organization during the times of this event if this request is approved. I further acknowledge that a copy of the ordinance may be found at the web address listed below.(Required)
https://coconino.az/DocumentCenter/View/42841/Ordinance-2021-02–WildfireDefense-Ordinance.pdf
A Variance is only for property, or locations within the Summit Fire and Medical District for only the event/work scheduled to take place on the date listed in #5 and place listed in #6.(Required)
Variance holders shall ensure that telephone or radio service is available at variance site to allow for prompt and reliable communication between the site and emergency communications center (911), in the event of emergency.(Required)
Authorized permit holders shall furnish adequate personnel (spotters & fire watch), fire tools (The ordinance defines adequate fire suppression equipment as, “personnel, tools, water, or other equipment suitable for the suppression of fire.”) This will vary based on the site’s location, size, fuel type, intended use, weather conditions, and other factors specific to each request. This may include, but is not limited to the items and materials listed below. It is the responsibility of the applicant to ensure that adequate fire suppression equipment is present at all times.(Required)
• Hand tools (shovels, rakes, etc.) • Water source • Fire extinguisher • Personnel (Spotters & Fire Watch) • Tractors, bulldozer, fire engine, on premises, etc. • Other equipment and supplies.
If a variance is issued, it is valid only under the current fire stage (Stage 1 or 2). If the fire stage changes, or critical fire weather conditions or winds exceeding 20 mph, the variance is automatically void. I understand I must reapply for a new variance if such conditions occur.(Required)
No variance will be issued when Stage 3 restrictions are in place for the location of variance. If the Stage 3 restrictions are issued AFTER a variance has been approved, the variance shall immediately become VOID.(Required)
A Copy of the approved variance shall be maintained on site during the times permitted in the Variance.(Required)
A fire watch must be performed for no less than 45 minutes after work is completed.(Required)
I understand that, by submitting this form, I am not automatically granted a variance, and cannot begin any activity/work until I receive written approval from Summit Fire and Medical District Management.(Required)
Summit Fire and Medical District does not recommend doing work outside the County Fire State restrictions unless there is a critical need being supported. A written variance issued according to this Ordinance does not relieve any person(s) or organization(s) from any civil or criminal liability outside the authority of this Ordinance associated with the activity and the potential for fire because of such activity.(Required)
Please contact the Summit Fire and Medical District Administration Office upon completion of this form. Hours of operation are Monday through Friday 8 a.m. to 5 p.m. Phone number 928-526-9537
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