125 BELCHER RD SPERMIT TO REMOVE TREE (S)
NAME OF
OWNER --T)R-
1 WY S
5eOr
OWNER'S
ADDRESS
1'2-5 '5- 13E'Lc%
Zg= (,'t Ptv'W/Ef -p- E
PHONE -71-7-5107
LOCATION OF TREE (S)
LOCATION OF TREES ON LOT •5Vr_- AC �rAjr,12
SPECIES AND NUMBER OF TREE (S) IAhJ I t`
TO APPLICANT. . non- refundable Fifteen Dollars ($15.00);::
fee is required for the first five (5)s,
trees to be removed plus Three Dollars
($3.00) for each additional tree.'''`
09759
RE5PN FOR REMOVAL:
Construction
❑ Hazardous
❑ Dead - Dying
❑ Other - (Specify)
Fee Rec: $ d3O . d 0
)l-
Rec't # 3 r -t 0
PLEASE READ AND SIGN:
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.. When'removal is requested for construction purposes, the Site Plan must
have a minimum scale of 1":0' for single family lots or •1 ":30' for. multi - family 'commercial .or industrial sites. The Site Plan must show:
1. Major Changes of Grade 9 ..AII Easements and: Rights -of -Way
2. Structure Locations All Protected Trees t Including:
3. Driveways and Walks A. Diameter (DBH) at 4� /a,It., above grade
4. Parking Arrangement (if any) �B:. Location SUrve ed) `
5. Required Number of Parking Spaces C Specesy !ter
6. Proposed Number of Parking Spaces.. � D: A ny Diseased orinsect Infested Trees
7. Underground Utilities to be installed y E. Designate ?reesaRequested to be Removed
8. All Setbacks per Zoning
2. Protective Barriers are required around all trees remaining on site during construction These,barricadesmust remain intact during construc-
tion as a citation will result if they do not remain standing and functional. Protective Barn s must fr)eet.City.Specifications per City Ordinance.
3. The replacement (Planting) of trees (Minimum Ht. of 6') may be required on your property before occUpancy is allowed. Trees are to be selected
from the approved list on file in the. Environmental Division: See in note below to determine the number of trees required when the
approved permit is returned to you.
I hereby certifiy 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 - identified property owner, and should It appear to be determined ttiat;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 Clhim made for wrongful removal of such
tree(s). I hereby certify that this a pI cation together with any plans submitted is a true ;representation of all-facts concerning the proposed removal
of the tree(s). Any deviation fro the permit issued shall render it null and vold and be considered a violation of Ordinance 1623, Section 3A,
Code f -Ord' ices.
Signature of pplicant if not owner Printed Name
Agency Representing & Phone ..Signature of Owner
1003 Date Received 3% Led
Address
City State
DO NOT WRIT
Inspec s Comments:
Recommended Repla ement Tr
Required Replacement Trees
Signed
Called /Mailed
PICKED UP
REQUIRED REPLACEMENTS
IS LINE _ Not Valid Until Signed By City Manager or his Designated Agent
Date
Based on the Inspector's comments and information submitt the above removal application is:
❑ Approwd As u itte proved — Modified As Noted Above ❑ Denied
Signed: Date:
City Manage or Designee
t/,t_ IdAr /feJ'.J urce
I
LESS ROAD HIGH I -OF -WAY OVLH I HL WLb I FOH I IUN I HLNt0I-. bLINU
Cf o PECAN TREE
LAGERSTROEMLA INDICA
CRAPE MYRTLE
® PAVING, GRADING AND
FURTHER DESCRIBED AS FOLLOWS:
WATER METER
8' HT.
D ETAI L P LAN
GRAPHIC SCALE
(T SANITARY MANHOLE
THE FLOOD ZONE FOR THIS PROJECT IS ZONE C,
AS FOUND ON FIRM MAP, PANEL NO. 125096
OWNM:-
038SITE4
DR. SCOTT TREFZ
COMMENCE AT THE NORTHWEST CORNER OF SAID SECTION 18; THENCE S
r0lv
IP
ILEX OPACA PALATKA
EAST PALATKA HOLLY
20. 0 10 20
000 08' 02" E ALONG THE WEST LINE OF THE NORTHWEST 1/4/ OF SAID
(813) 797-5107
8' HT.
SEMINOLE ENGINEERING, INC.
I 1
11
SECTION 18, FOR 144B.96 FEET; THENCE LEAVING SAID WEST LINE,
CL WATER, FL 34602
(813) 539-0051
REPRESENTATIVE: JOHN S. KETTELL
S 89® 31' 47" E, FOR 50.00 FEET TO THR POINT OF INTERSECTION
TREE SETBACKS:
IN FEET
WITH THE EAST RIGHT-OF-WAY LINE OF BELCH ER ROAD FOR THE POINT
UNDER TORY TREE
1' TO PERIMETER
20
OF BEGINNING; THENCE LEAVING SAID EAST RIGHT-OF-WAY LINE,
INTERMEDIATE TREE
3.5' TO PERIMETER
I inch = 81t~
CONTINUE S 890 31' 47" E, FOR 270.82 FEET, THENCE S 00' 00' 26" W.
CANOPY TREE
5' TO PERIMETER
07-16-93
038SrrFA
FOR 100..00 FEET., THENCE N 89- 31' 47" W, FOR 270.58 FEET TO THE
q
POINT OF INTERSECTION WITH SAID EAST RIGHT-OF-WAY LINE;
THENCE N 00" 08' 02" W, ALONG SAID EAST RIGHT-OF-WAY LINE, FOR
100.00 FEET TO THE POINT OF BEGINNING AND CONTAINS 0.621
03ECTION 18 TOWNSHIP
!"I ELLAS COUNTY, FLORIDA
LWARA W�004
rlklvm_b�. ��
SITE
LOCATION
LOCA'nON MAP '
TRANSPORTATION IMPACT FEE SCHEDULE AT TIME
OF PERMITTING SHALL BE THE AMOUNT CHARGED.
CONTRACTOR TO CALL "CANDr AT 1-800-282-88811
48 hrs. PRIOR TO ANY CLEARING OR CONSTRUCTION
FOR EXISTING UTILITY LOCATIONS.
DATE
07-12-93
�RAWN b
DBH
PROPERTY LINE EXISTING SIDEWALK
FYlqTlMr FFNrp
EROSION CONTROL NOTE:
EROSION CONTROL DEVICES TO
BE PLACED ONE ON THE
PROPERTY LINE.
HAMICAP NOM-
HANDICAP SPACE TO BE PAINTEI
ENTIRELY BLUE NTH SIGN ON
VERTICAJ- POST.
INDEX:
Cf o PECAN TREE
LIGHT POLE
PLAN
® PAVING, GRADING AND
Z—V 0 CLEANOUT
WATER METER
FLOQQ- ZONE NOTEL
D ETAI L P LAN
OH— OVER HEAD WIRE
(T SANITARY MANHOLE
THE FLOOD ZONE FOR THIS PROJECT IS ZONE C,
AS FOUND ON FIRM MAP, PANEL NO. 125096
OWNM:-
038SITE4
DR. SCOTT TREFZ
r0lv
SEWER LINE
SPOT ELEVATION
0016B, REVISED JUNE 1, 1983.
TRANSPORTATION IMPACT FEE SCHEDULE AT TIME
OF PERMITTING SHALL BE THE AMOUNT CHARGED.
CONTRACTOR TO CALL "CANDr AT 1-800-282-88811
48 hrs. PRIOR TO ANY CLEARING OR CONSTRUCTION
FOR EXISTING UTILITY LOCATIONS.
DATE
07-12-93
�RAWN b
DBH
PROPERTY LINE EXISTING SIDEWALK
FYlqTlMr FFNrp
EROSION CONTROL NOTE:
EROSION CONTROL DEVICES TO
BE PLACED ONE ON THE
PROPERTY LINE.
HAMICAP NOM-
HANDICAP SPACE TO BE PAINTEI
ENTIRELY BLUE NTH SIGN ON
VERTICAJ- POST.
INDEX:
1 SITE AND LANDSCAPE
PLAN
® PAVING, GRADING AND
UTILITY PLAN
PAVING, GRADING AND
DRAINAGE
D ETAI L P LAN
PROJECT No.
SURVEY PLAN
OWNM:-
038SITE4
DR. SCOTT TREFZ
GULF BAY ANIMAL HOSPITAL
-4
125 SOUTH BELCHER ROAD
FIELD BOOK No.
CL WATER, FL 34625
(813) 797-5107
ENGINEER:
SEMINOLE ENGINEERING, INC.
14483 62nd STREET NORTH
CL WATER, FL 34602
(813) 539-0051
REPRESENTATIVE: JOHN S. KETTELL
SITE AND LANDSCAPE PLAN
;f*t,
-
DWG. FILE No.
PROJECT No.
038SITE4
91-030
-4
FIELD BOOK No.
E . SHEET NO.
, Wl
ES 8313
I OF 5
DATE,