415 ISLAND WAYC.
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A
CITY OF CLEARWATER - PLANNING & DEVELOPMENT SERVICES
TREE REMOVAL PERMIT
NAME OF OWNER M LL
SITE ADDRESS _(A S
PHONE
OWNER'S ADDRESS QIZ:) h = r
LOCATION OF TREE(S) ON LOT 3 M. d A t
SPECIES AND NUMBER OF TREE(S) QA-1 M5
TO APPLICANT: A non - refundable fee of $15.00 for up to five trees'to
be removed, plus $3.00 for every tree above 5 to be
removed is required.
REASON FOR REMOVAL!
• Construction
•See "A" below
• Hazardous
• Declining
• Dead
• Other (Specify)
Fee Recd. $
A) CONSTRUCTION Date
1. For new construction, additions. or other modifications of a property which involve the removal of a protected tree(s),
a site plan is required. This site plan must have a minimum scale of 1 " =20' for single family lots, or 1 " =50' for all others. The
site plan must include:
a. Major Changes of Grade f. Proposed Number of Parking Spaces J. All Protected Trees Including:
b. Structure Locations g. Proposed Underground Utilities Q.) Diameter of 4.5' above grade (DBH)
c, Driveways and Walks h. Zoning Setbacks (ii.) Surveyed Location
d. Parking Arrangement i. All easements and Rights -of -Way . (Iii.) Species
e. Required Number of Parking Spaces (iv.) Diseased or Insect Infested Trees
k. Tree Barricade Detail & Locations
2. Protective barriers are required around all trees remaining on site during construction. These barricades must remain
Intact during construction. The barriers must, meet City Specifications.
B) REPLACEMENTS
1. Tree replacement minimum standards: 10' overall height 2.5" caliper, Florida Grade #1. See inspectors note below to
determine the number of replacement trees required. Replacements required within 30 days.
I hereby certify that as property owner or as representative of the property owner, I have verified that the tree(s) sought
to be removed is wholly on property owned by the above- identifled property owner, and should it be determined that
the tree(s) are located wholly or partially on property owned by some other person, then, I agree to hold the City of
Clearwater harmless in any claim made for wrongful removal of such tree(s). I hereby certify that this application together
with any plans submitted is a true representation of all facts concerning the proposed removal of the tree(s). Any deviation
from the ermit Issued shall render it null and void and be considered a violation of the Community Development Code.
�Slgnaure of owner or applicant Printed Name
Address Agency Representing OCL #
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uv NUI WKI I t bLLUW THIS LINE - Not Valid Until Signed By City Manager or his Desianated Anent
Inspector's Comments:
Required Replacement Trees:
Applicable Code Section:
Based on the Inspector's comments and information submitted, the above removal application Is:
D Approved as Submitted Approved- Modified as Noted Above ❑ Denied
Slgne hAL1__ Date: 2 2
Community evelopmeni Coordinator or Designee /Inspector Valid for six months from the date of Issuance.
1362.0001 -GC White - Planning & Development Services Yellow - Applicant Rev. 2-03
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NOTE. ALL TREE STAKES AND SUPPORT WIRES
WILL BE REMOVED AFTER I COMPLETE
G20 WING SEASON,
For Cabbage Palm InstallotJon;
For Cabbage PoIrnat
Trim All Fronds at Time
All Trunks to be Smooth and
of Digging and Planting
f 1 7
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Al Bum Marks Brushed Away
For WooWnI PcIm In3tallatkirr
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Leave inside row of fronds
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Leave all an trunk
AIR�.
1 `D%EL1A
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GROWING SEASON,
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2 Layers Burlap Pad at
Remove Dead and Injured
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W.
Fails In tree Wood
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W;re Tie
Retain Natural Shape.
NOTE. ALL TREE STAKES AND SUPPORT WIRES
WILL BE REMOVED AFTER I COMPLETE
G20 WING SEASON,
For Cabbage Palm InstallotJon;
For Cabbage PoIrnat
Trim All Fronds at Time
All Trunks to be Smooth and
of Digging and Planting
f 1 7
L
Al Bum Marks Brushed Away
For WooWnI PcIm In3tallatkirr
For Wash, Palms:
=
Leave inside row of fronds
<
Leave all an trunk
Tie up with biDdegradablil twins
LL_
GROWING SEASON,
LLJ
2 Layers Burlap Pad at
Remove Dead and Injured
Support Contact — Me
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W.
Fails In tree Wood
0
LLJ
W;re Tie
Retain Natural Shape.
3/4" — 2 Ply Reinforced
2' as 4' El,acm (Yellow W a)
4
Space Three at 120' Typical
.2
Remove after one growing season.
2® x 4' Stake (Yell ow Pinc)
< LU
Three Feet Long
Remove after one growing season.
Saucer ffirn
Duckbill Anchors Or Equal
FsCSiSti Graff
Remove after one grooving season.
4 Min.
3' Mlnlmum Mulch
Rootball, 16' Minimum
Mound To Form Saucer
RedUs Frorn Trunk
Washed—in and Tamped
III
Picriting &61 mixture
5d*tIng Soil
IN
V II i III 11 10
UVAIVRE"21i
-42 a WIMM,
o. AN APPLiCATION AND AN EXTRA COPY OF THE APPROVED FIN
APPLICATION PLAN MUST BE SUBMITTED TO THIS DEPARTMENT I NJ
ORDER TO PROCESS THE PERMIT,
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3" Minimum Mulch
4, IF ON SITE SOIL CONDITIONS ARE SUCH THAT SOIL AMENDMENTS
WILL BE NECESSARY, THE PLANTING MUST INCLUDE SOIL MIXTURE
THROUGHOUT THE ENTIRE SECTION OF EACH PLANTER AREA TO A
DEPTH CONSISTENT WITH THE ROOT DEVELOPMENT OF PROPOSED
PLANT MATERIAL,
5. PLANTERS ADJACENT TO OR WITHIN VEHICULAR USE AREAS MUST
BE CONSTRUCTED SUCH THAT LIMEROCK, ASPHALT, CONCRETE OR ANY
OTHER OBSTRUCTIONS DO NOT EXTEND UNDER THE SURFACE INTO
THE PLANTING AREAS.
NOTE:
ADEQUATE FLANTING FREE OF
UNDERGROUND URLITIES WILL BE USED.
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NOTE. ALL TREE STAII.ES AND SUPPORT WIRES
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GROWING SEASON,
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Remove Dead and Injured
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W.
IN
V II i III 11 10
UVAIVRE"21i
-42 a WIMM,
o. AN APPLiCATION AND AN EXTRA COPY OF THE APPROVED FIN
APPLICATION PLAN MUST BE SUBMITTED TO THIS DEPARTMENT I NJ
ORDER TO PROCESS THE PERMIT,
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3" Minimum Mulch
4, IF ON SITE SOIL CONDITIONS ARE SUCH THAT SOIL AMENDMENTS
WILL BE NECESSARY, THE PLANTING MUST INCLUDE SOIL MIXTURE
THROUGHOUT THE ENTIRE SECTION OF EACH PLANTER AREA TO A
DEPTH CONSISTENT WITH THE ROOT DEVELOPMENT OF PROPOSED
PLANT MATERIAL,
5. PLANTERS ADJACENT TO OR WITHIN VEHICULAR USE AREAS MUST
BE CONSTRUCTED SUCH THAT LIMEROCK, ASPHALT, CONCRETE OR ANY
OTHER OBSTRUCTIONS DO NOT EXTEND UNDER THE SURFACE INTO
THE PLANTING AREAS.
NOTE:
ADEQUATE FLANTING FREE OF
UNDERGROUND URLITIES WILL BE USED.
12% WA
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NOTE. ALL TREE STAII.ES AND SUPPORT WIRES
f 1 7
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WlU_ BE REMOVED AFTER 1 COMPLETE
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GROWING SEASON,
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Remove Dead and Injured
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Trigs, TrIm Na Leaders,
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Retain Natural Shape.
3/4" — 2 Ply Reinforced
4
Rubber or Plastic Hose
CD
White Syrveyor's Tagging
Tape, 6 Length
< LU
3 — 12 GuGalvanized Wires
Spaced 120 ground ee 2n
il
Set At A 4-5'Angle � ,, . 1 58
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Duckbill Anchors Or Equal
Remove after one grooving season.
4 Min.
Mound To Form Saucer
III
3" Minimum Mulch Layer
EB
#593 6
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Remove Burlap From
Around Top 0 Ball
Planting Soil Mixture
Provide a nn"ininnum 5x 1 D'
unobstructed planting area
12% WA
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Issue Date- 04/01/05
Revisions:
13UTLER �5 NURSERY. EVC,
5
7017 75TH ST N, PINELLAS PARK FL. 3,3781
PH.-(727)544-044-5 FAX,-(727)54-1-5027
E-MAIL: BUTLERSNURSERY@MSN. COM
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NOTES
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UNKNOWN TREE
PALM TREE
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ALL ROOF DRAINS SPOUTS TO
DIRECTFLOW INLETS]
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TREE LEGEND:
OAK TREE
C3
UNKNOWN TREE
PALM TREE
RAMA. GOELPh.D. P.E. #4743 APR 2 8 2005
COPIES OF THESE PLANS ARE NOT VALID UNLESS
EMBOSSED Wmi THE SIGNING ENGINEER'S SEAL
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