3410 GULF TO BAY BLVDSEAI�n.
�i01" �'�a APPLICATION FOR LAND CLEARING & GRUBBING PERMIT
CITY OF CLEARWATER
TEW. PLANNING & DEVELOPMENT SERVICES
One City. One Future. (727) 562 -4741 DATE ( Z
RECEIPT NO. -L-
0111 Ski.`,
A non - refundable filing fee of $10.00 is required. Permit applicable for 6 months from date of approval.
In accordance with the Community Development Code, I hereby apply for permit to land clear and /or grub the
property described below. (D
1, Location of Property: - % �%G 7 ) P, ( 3
2. Project Name: CfC:7a( '�z ECILT 7_1 I116?01L VL ill( C L,0 U6 "E r 4
3. Purpose of clearin `and /or rubbing: }
r� New Construction ❑Demolition ❑Tank Removal ❑ Others- `�;
4, General description of existing vegetation, topography, and surface water (including all existing and /or proposed yrj
ditches, canals, and swales) V) G "f, s O
5. Proposed method of debris disposal "1 (`� i t-- AIAJ A"� C7
.i�,A Date you plan to begin work � f
11 7 Proposed method of soil erosion control { �" T `d C Ek �` } )° �., T l h.? � 72 / ;I o r 1 ffJ
8.. No -Tree Verification Require ❑ Tree Removal Permit Required
I AM AWARE AND UNDERSTAND THE REQUIREMENTS OF SECTION 52.08, CITY CODE OF ORDINANCES REGARDING
TREE PROTECTION DURING CONSTRUCTION AND ARTICLE 3, DIVISION 7 OF THE COMMUNITY DEVELOPMENT CODE
REGARDING EROSION AND SILTATION CONTROL. Ig119
Signature of Owner or Owners Representative
Printed Name
Address
City State Zip
L
Representatives' Firm ry ( 7
Telephone Fax
Applicant must include Aerial Photograph or Scaled Site Plan showing property boundaries and limits of work. This is
NOT a Tree Removal Permit.
DO NOT WRITE BELOW THIS LINE
Land Resource Comments:
(�A
Based on the above comments and information submitted, the above clearing & grubbing application is:
❑ Approved As Submitted I!J)Approved - Modified As Noted Above ❑ Denied
..
. °" 1+-�- Date: ?cJ'
Signed: �.•�- - ��
City Manager &,0esignee
One City. One Future.
Brian J. Aungst, Mayor- Commissioner
Ed Hooper, Vice Mayor- Commissioner Bob Clark, Commissioner Ed Hart, Commissioner J.B. Johnson, Commissioner
1362- 0002 -GC White - Applicant Yellow - Planning & Development Services
8 -99
BCP2001-07308
NO TREE VERIFICATION
or
99�ATER- NO TREE REMOVAL PERMIT REQUIRED VERIFICATION STATEMENT
CITY OF CLEARWATER
PLANNING & DEVELOPMENT SERVICES
(727) 562 -4741
(Print or Type)
Owner: Gl'f-H Dr G eAYZu1 ATM Phone: 2- 41S-D
Owner's Representative: 63 I-t_-� `- 6Prl -W1 Gk- ,3-P_ Phone: StaQ -41 &D
Address of Applicant: I DD S• LY P-T 97 4VE
City: State: L Zip: _33 ?s zo
Location of Proposed construction: _941y TD 6m j 6-W o
Clearwater, Florida
I hereby certify that the information contained herein is true and accurate and that I am the legal owner of the
subject property or have legal authority to execute this form on behalf of the property owner. I am aware that any
deviation from the information submitted with this form shall be considered a violation of the Community
Development Code. In accordance with Section 4 -1205, Community Development Code, I request a release from
the provisions of the tree removal permit section to allow the issuance of a building permit at the above location
because one of the following conditions exists:
PROTECTED TREES, as defined in Section 8 -102 (non - prohibited species greater than four inches at 4.5 feet above
grade) exist on the site, but ARE NOT REQUIRED TO BE REMOVED FOR CONSTRUCTION purposes, thus no tree
removal permit is required. I further understand that these TREES MUST BE PROTECTED FROM DAMAGE BOTH
BEFORE AND DURING ALL CONSTRUCTION ACTIVITIES ON THIS SITE as provided in Section 52.08 of the City code of
Ordinances (A site plan is submitted with this request.)
O NO PROTECTED TREES, as defined in Section 8 -102 (non - prohibited species greater than four inches at 4.5 feet
above grade), EXIST ANYWHERE ON THE SITE of the proposed construction.
PRINTED NAME: GLGFO L- &4f-f- t c_K-- , `J je-.
Owner or Representati, e j
SIGNED: �' % %✓/ r `
Signature of Owner or Representative
Whitney Gray, Commissioner
CLEARWATER
Brian J. Aungst, Mayor- Commissioner
Hoyt Hamilton, Commissioner Ed Hart, Commissioner
Bill Janson, Commissioner
1430- 0022 -GC White - Planning & Development Services Yellow - Applicant 4 -01
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