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600 BAYWAY BLVDCITY OF CLEARWATER - PLANNING & DEVELOPMENT SERVICES TREE REMOVAL PERMIT NAME OF OWNER 3AY HAIZ R" LL- "E-- SITE ADDRESSc �e' PHONE E3 I - Ct ��-- OWNER'S ADDRESS 03 KL F65M-DA LOCATION OF TREE(S) ON LOT SPECIES AND NUMBER OF TREE(S) TO APPLICANT: A non - refundable fee of1$15.00 fgo§es be removed, plus $3.00 for every wabove 5 to I removed is required. REASON FOR REMOVAL: l6onstruction -,See "X below ❑ Hazardous • Declining • Dead • Other (Specify) Fee Rec'd. $ Date A) CONSTRUCTION 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 I'=--W for all others. The site plan must include: a. Major Changes of Grade b. Structure Locations c, Driveways and Walks d. Parking Arrangement e. Required Number of Parking f. Proposed Number of Parking Spaces g. Proposed Underground Utilifies h. Zoning Setbacks 1. All easements and Rights -of -Way Spaces J. All Protected Trees Including: (I.) Diameter of 4.5' above grade (DBH) (lt.) Surveyed Location (ill.) Species (tv.) 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: l0' overall height 2.5" calipm 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- identified 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 per ed hall render it null and void and be considered a violation of the Community Development Code. PAB- L� �z Signature of o ner r applicant Printed Name -I- IQ 1� ©L2 eo��tJc ©�I Tess Agency Rppresentin OCL # ML.4 } rr(- 30,6$.3 �Z7- �� `7LV-d38 7 City State Zip Phone /Cell Fax DO NOT WRITE BELOW THIS LINE - Not Valid Until Signed By City Manager or his Designated Agent Based on the Inspector's comments and Information submitted, the above removal application is: O Approved as Submitted Approved- Modified as Noted Above D Denied Signed: Date: 0 S Communi Develop nt Coordinator or Designee /Inspector Valid for six months from the date of issuance. ....,...,.n+ .... �AM1 14- . 01--i v+ a. n...n.l..nr..cn +4nnA -• a Vc11~ - Ann{irnnt Rev. 2-03 • D m 7, i 0 FPKND'' PR PLS 5053 maQ C 20 4-0 10 LEGEND: DENOTES WOOD POWER POLE DENOTES GUY WIRE & ANCHOR 0 too = DENOTES GROUND ELEVATIONS .-X.XX C,t . a t x.00 3';q 90 q w l""'p """p '"'..'j CD = CHORD BEARING CONC. = CONCRETE V = DF TA «1 e m p qk C. XUK )NC. RKIN, 0 o} OT 8 0 ' ' " "rY, FUOR A 0 maQ C 20 4-0 10 LEGEND: DENOTES WOOD POWER POLE DENOTES GUY WIRE & ANCHOR X.XX = DENOTES GROUND ELEVATIONS .-X.XX = 'DENOTES EDGE OF PAVEMENT X.XX = `DENOTES TOP OF CURD A = ARC DISTANCE BFP = BACK FLOW PREVENTER CD = CHORD BEARING CONC. = CONCRETE n = DF TA CLEARWATER HARBOR EX. BOATDOCKS TO REMAIN--\ N no w go I sod + Scientific Name Common Name Code Name @ 77 + + Ixor(7 "Norc Grant" Nora Gron t NG J—Gol,247x24" 3 20'x2O' 01ANG low \—EX Oleander SP 2'-Cal, VMAU CURB O'x2O' I 85 fro dodor pus mocrophyllus TRIANGL PD J— Gal, JO "ht EXI SAN. Sabol palmetto Palmetto SP EL.* 5�4 INV. L67 OW101, E Is M N .53 A V�') N In Quon tity Symbol Scientific Name Common Name Code Name Plonting Size 77 Ixor(7 "Norc Grant" Nora Gron t NG J—Gol,247x24" j. Nerium oleander Oleander OL 2'-Cal, 8h t 85 fro dodor pus mocrophyllus Yew podocarpus PD J— Gal, JO "ht 4J Sabol palmetto Palmetto SP B & B, 14'+ct L 7 T o e buic argentea Gold Tree Ts 2 112 cal, i O'h t 115 Viburnum odoratissimum owabuki Awabuki Viburnum AV J—Gol,247x24" J4 e n n is e t um �s e t �a e u m W H �_FOG�U N �TC RASS�S PS J—Go1,J0"HT N unt q N q ANY CHANGES IN SPECIES, SPECIFICATIONS, OR DIESGMMTHOUTTHE CONSENT OFTIME PMWNG DIR'ECTOR RENDERS 1% APPROVAL VOID, ALL AREAS BETWEEN STREET PAVEMENT AND PARMNG LOT TO BE TURFED OR RECEIVE OTHER LANDSCAPING TREATMENT, P�J.1 LANDSCA SIN G TO BE PROTECTED FRONM VIL RI! CUL!\R 01) PEDESMr*1 TRAFFIC BY 1,1k M 9 CH HIGH CUUN G ORWHEEL STOPS. Issue Date: 09117104 Revisions: (,I rA19 /,qm/py 00,/ Fl j. L (,I rA19 /,qm/py 00,/