A person, firm, or corporation, or a group or combination of persons, firms, corporations, or groups, that owns or controls brush-covered

land, forest lands, woodland, grassland, shrubland, or any combination thereof within a state responsibility area may apply to the department for permission to utilize prescribed burning for those public purposes set forth in subdivision (a) of Section 4491. The application shall be on a form prescribed by the department and shall contain a description of the lands and other pertinent information that the department may require.