This form is meant for the sole purpose of providing the Burnsville Fire Department with photographic or video evidence that may be useful for fire department documentation, investigations and inspections. Do not put yourself in harm's way to capture a photo or video. Always follow all directions given by authorities (police or fire) such as closure, evacuation and hazard warning both written and verbal.

First and Last Name*

Email Address*

Best Phone Number to Reach You*

Alternative Phone Number

Date and Time Photo/Video were taken.*

Location of Incident

Street Number and Name

City:*

Please provide any details you may have of the surroundings and vantage point from which the photo/video was taken.

Comments

Terms and Conditions
Any photo(s) or video(s) submitted will become the property of the City of Burnsville. They can be used for fire and criminal investigation, training, City or fire communications or for any other purpose which the City sees fit. I understand that the City may contact me to gather more information in regards to the photo(s) or video(s) that I submit and I agree to provide information to the best of my ability.*

Yes

Upload Photo/Video*

Upload Photo/Video

Upload Photo/Video

Upload Photo/Video

Upload Photo/Video

Upload Photo/Video

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Upload Photo/Video