1091 ELDORADO AVEPERM17 °'T0 REMOVE TREE (S) _
14 56 �} '
NAME -OF OWNER G4l eLp�iC
C REASON FOR REMOVAL:.
OWNER'S ADDRESS
YConstruction
' PHONE y:d .`j � �.. 1 Hazardous
❑Dead Dying
' "LOCATION OF, :TREE {S)Go• z
{ ❑ Other (Specify)"~;.•
LOCATION rOF'TREES, ON LOT, #
SPECIES AND' NUMBER OF TREE
TO APPLICANT: A non refundable three dollar $3.00�fee is,re- ° . Fee.'Rec.
r , qui`ed for'each tree requested to Abe- removed. Rec't # '
t
s PLEASE READ AND SIGN:'
2,
,,�y��1�•:On�New construction, additions, or other modifications of a property which requires the removal or relocation of,a protected tree(s) (Larger
. *, ". than`4" in diameter at 41/2 ft. above grade), a Site Plan is required..lNhen' removal is requested for construction purposes., the Site Plan must
:. have' a- minimum•scale of 1":0' for single family lots ±or.1 30' formulti, family; commercial or industrial sites. The Site. Plan must show: '
Ar.
1 Maor+Chan es of Grade + 9. All Easements and Ri hts- of -Wa'
�' 1 9 g Y;t�
2. Stru pure Locations _ 10. All Protected Trees _ Including: R ,
:! 3 Driveways and`Walks.... A. Diameter (DBH) at 4� /z ft. above grade '
B. Location Surve ed
i �4 .Parking Arrangement (if any) ( y )
5 Required Number of Parking,Spaces t ` C. Species ,
- 6 Proposed Number of Parking Spaces '� D. Any,Diseased or Insect Infested -Trees
` 7i Underground Utilities tolbe installed ± ,. E. Designate Trees Requested to be Removed _.• , y �° }`
S((etbacks, per Zoning���
t, 2: Protective Barriers are required around all trees remaining on site. dunng,construction. The"se,barncades.must remain intact during construc W, tt
'r'tion as a citation will result if they do not remain standing and.functional. Protrective Barriers must meet City Specifications per City Ordinance
1623:' 1 t jYis3
3. The replacement (Planting) of trees (Minimum Ht. of 6') may be required on your property before yoccupancy is allowed. Trees are to be selected #<
from the approved list on file in the Environmental Division. See inspectors note below to determineahe number of trees required whensthe
approved permit is returned to you.
I.hereby certifiy that as property owner or as representative of the property owner, I have verified that th "e'tree(s) sought to be removed is Aolly
on property owned by the .above-identified property owner, and should it appear to be determined that the,tree(s) are�located wholly or partially
r 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 Ht
V, tree(s). I. hereby certify that this application togetherwith any plans submitted is a true repi esentation of all facts cQncerning.the' proposed removal Y
of the tree(s): Any deviation from the permit issued shall render it null and void and be considered .a violation of Ordinance 1623, Section 23A,
Code of Ordinances•.; r?''
ti 1 �•• :�. '« �` .its
. a, '�* `�' $ ,..�• /J � � err- �'� 7` �' t ,R�
` � j i • ..., . /�•Yi1'°`" -�i A' � / .Jv 1 'pelt /�' ./ _ f �� .
'Signature of Applicant knot owner t Printed'Name "
A.
t
Agency. Representing &.Phone z Signature of Owner'}
2 o SIS" as / 9 Date Received V � 1
Address
Called/Mailed
CG/''rLYJ7rl2 G r PICKED" UP t ,.
s
4i City State
REQUIRED REPLACEMENTS
DO'NOT, WRITE BELOW THIS LINE —.Not Valitl Until Signed•By CittyyP/ n�ageer-r -;or his De iigpated Agent
,/.
"Inspector's _Comments; .•*�-- ����� -�
5
y.. h • , - `,y yh s� :'r'_ f+'' iC_%%.'��ir,i•C icw✓� s.. vJ.i�'.�� {/ ,,f.�.
Recomrn 3nded, Replacement Trees
Required Replacement Trees- � •����/r i� .
gned; �(/la1 Date ; )
Inspecto
t E (Based on the.lnspector "s comments and information submitted the above removal application is:
+ '
El As Submitted Approved , , Modified As Noted Ab %ove ❑ Denied '
Signed: f ' �/L Date / If�
R`r City Manager or Des gnee!- -..
�. i+'re*':ra..:3twi -.d% ifs .+'ti,;e"�,.F•IhA.fi'�i�"'�v"Ir b? �4r—' V�. pe" �v%"'�u"3ii�.�v+^'�'Sperw».Ta, !t-w ,.� tt,.�:aw.rs .,.yw c a rw.t.•r 3. c.,,.,.. v..'' r' ?^ ws�%"'' 111rr:+ ti' rrY' �fy3rM.: v .M��'4'�l�ra+-fer.+o'''n*rnr, ,
APPLICATIONH FOR LAND CLEARING & GRUBBING PERMIT ?�
%�,
CITY OF CLEARWATER
` PUBLIC :WORKS DEPARTMENT
ENVIRONMENTAL MANAGEMENT DATE
'(813) 462 -6747 RECEIPT NO '713115,' 1 15, .
A non- refundable filing fee'of $10.00 is required per Resolution 86 -9. Permit applicable for 6 'months from.date of approval. f �
In accordance withiSect'ion'98.30, 1- hereby apply'for` permit to,,
land clear and /or grub the property described below.
1. Location of .Property /09i EG dr7�2/9c� r t' 1
2. 'Project 'Name,
041Z e, 41ler, ;Yr afi; C 6 a # '
',3.. Purpose of'clearing and /or. grubbing
:r 4. General description of existing vegetation, topography; and surface water (including all "existing and /or proposed'
" 4 r ti
ditches,, "canals, . and swales) %''A1✓7'A0 �:,� G ct/_rG �D ou,►v� %�✓: Si1'li9�l /S'c� r�S r ' ;
I?roposed method;of debris disposal���n TF2 t
6 Date`�you plan to begin' work
{ ` 7 Pro_pbs6dtmethod: of soil` erosion control ► • �R
-'A
t 8. 0.,No- Tree' Verification. Required El Tree Removal Permit Required v
,tYl AM AWARE AND UNDERSTAND THE REQUIREMENTS OF SECTION 98, CITY CODE OF ORDINANCES REGARDING
PROTECTION DURING CONSTRUCTION AND HAVE READ CITY'S EROSION AND SIL.TATION•CONTROL POLICY
Subscribed and Sworn before me ,
Signature of Owner oj1Owners Representative , t
this dayi of, r 19 ;
Printed Name
y4$ �R S" " 1 /✓dl�. % "lv�: - a _ a fit. . r �,r.
Signatui�e,of Notary
Addressr �.
NAME OF.N'OTARY
r }2r
City .State Zip .COUNTY'
i COMMISSION EXPIRES ,
-Y• Representatives Firm Telephone r
# 4 Applic'ant'must include Aerial Photograph or Scaled brawing showing property boundaries and limits of,work. This is NOT'
b �t r, a Tree Removal = Permit. � s\
Y . DO NOT WRITE BELOW THIS LINE
1
�� 'Cam ents
t i L ° 5 9 .�� -mss - $;♦ -. ;. :.t
r . ., r - _' - mod; s , _ ,g- • 7'
eso rce•Spec Date
Comments a a
tl:
6r9an Fqr,6 er Date ( .
- Based on .the above comments and information submitted, the above removal applica'fo.n is:
,.. ;
( - "Approved As Submitted ❑ `Approved — :.Modified As Noted Above L 'Denied.,
Signed. Date�� l�
City, Manager or Designees =
Rev. 9/97 ..'
1�
White — Applicant Yellow Evi
nronmental Pink Inspector
APPLICATION FOR LAND CLEARING & ,GRUBBING PERMIT
CITY OF CLEARWATER
PUBLIC.WORKS DEPARTMENT
ENVIRONMENTAL. MANAGEMENT DATE
(813) 462 -6747 RECEIPT NO. ZY 7
A non - refundable filing fee of $10.00 is.required per'Resolution 86 -9. Permit applicable for 6. months from date of approval.
In accordance with Section 98.30, I. hereby apply for permit to land clear and /or grub the property described below.
1.: Location' of Property _1 noQ
2: Project Name _o Vic_ ��r u- t r�-t c�2 i�� /S r,r� �+
fit? t ci
3. Purpose of clearing and /or grubbing Dy6,1 xx`�-r r1 c-. -c�uc-��►�zc=
4. General description of existing vegetation, topography, and surface water (including all existing and /or proposed
ditches, canals, and swales �",dr_t..� t2 &lam us-ra�.i 5•� ` � `�-
I�1J 11: , � i � � � H �► �:2 iit..:t_`a� �i -A"r- �v � � L� f2 dim �- � . . C�c3� '�c.c ra �ru F `�A. R.,�i'ar•�
5. Proposed method of debris disposal
6. Date you plan to begin work ,��c,�f
7 -Proposed method of soil erosion controltJ'T3
8. El No-Tree Verification Required Tree Removal Permit Required
I AM AWARE AND UNDERSTAND THE.REOUIREMENTS OF SECTION 98, CITY CODE OF ORDINANCES REGARDING
TREE PROTECTION DURING CONSTRUCTION AND HAVE READ CITY'S.EROSION AND SILTATION CONTROL POLICY
ry
Subscribed and Sworn before MeR
Signature of Owner or Owners Repfehentative this h day of tl AlAt rl / `, 19
Printed Name''
7 K:
� Signature of Notary
Address ,
NAM OF NOTARY
City State Zip COUNTY ��il':`'IGiS.
�tLl.(,- 2_Zt -> j. COMMISSION. EXPIRES.
Representatives' Firm Telephone
Applicant must include Aerial Photograph or Scaled Drawing showing property boundaries and limits -of. Work. This is, NOT
a Tree Removal Permit.
DO NOT WRITE BELOW THIS. LINE
Comments /'�" �V2 to T 5�, I Nit elk, _ d e b ri S yt�v�a �a.r- e v Svc Dtc,,���C-
M- W Gt r C e .� ry e I' �S ova S fd r,+-r :5U� c.� e 6^
_ r D �_
k4 .s ;� t a. e �f Ce v e cz S rJt� e S7' d %i Z e c /� S S b� r�yc
DOSS /f /�� J �c�C/r` / /Ze r/k:_5 s Vt., C'Tir Guest- YCe.t;� Ce;� 70 ,%y Qv @�t�,/ �v
0 OA r
f (4 r/ CLAY: fe 6{ Sie.� 6
• 7
Water Resource Spec. Date �.
Comments
An
r- U�rbW ror-ester Date
Based on the above comments and information submitted, the above removal application is:
�� Approved As Submitted ❑ Approved - Modified As Noted Above E1, Denied
Signed: \ 4 :� _ • Date:
City Manager, or ;6esign /ee v /
Re'v: 9/87
White— Applicant Yellow — Environmental Pink — Inspector '
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