1012 DRUID RDS� CITY OF CLEARWATER - FORESTRY DIVISION
TREE REMOVAL APPLICATION FORM
NAME OF OWNER: �� J�v
LOCATION OF WORK:
2947 P
Fee Rec. S C
Date Rec: - C:1-
Rec. By:
R 't# Z //7S
Clearwater, FL
Cam•
REQUIRED REPLACEMENT TREES
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TREE REMOVAL PERMIT
2947
NAME OF OWNER 4 • '-JA-4W
OWNER'S ADD RE, 0 1 ()
PHONE
SITE ADDRESS J
LOCATION OF TREE(S) ON LOT E.2
SPECIES AND NUMBER OF TREE(S) oi C o"o-V L- OR kL, S
i i,Scos c o c09J4f_ 46A-Oad 3�
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
0 Hazardous
%Declining
0 Dead
O Other (Specify)
Fee Rec'd. S
Receipt # 62 105-L
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 ' . *mot :' Ail easements and Rights -of -Way
b. Structure Locations `'r ti j,T ``t $ ti,;; ' 1' ;All Pnotectecl -Trees Including:
c, Driveways and Walks ) Dlametet'oi 4.5' above grade (DBH)
d. Parking Arrangement 'F�; ' r °r,�r,'1'(fi.) Surveyed location
e. Required Number of Parking Spaces. rr r °x. ,mayj�rj�rllj!!��({ (i �s:.
f. Proposed Number of Parking acct .t;.x r' 3 :e� ;.� '�' '��,,� (Iv ):Diseased -ot Insect Infested Trees
po ng Sp .1..7. rY b�._
g. Proposed Underground U titles , . f Y ' (v j Trees to k e. Removed
h. Zoning Setbacks 1 . * k:.' Tree Barrlcade'Detail &Locations
2. Protective barriers are required around all trees remaining on site during coristit rction. These barricades must remain
Intact during construction. The barriers must meet' City Speclflcdtlons
3. Tree replacement minimum standards. 8, o ierallhelght, 2' cdllper, Florida Grade. #i.,See"In�ectors note below to
determine the number of replacement: frees re( ulred.�
I hereby certify that as property owner or:as representative of the propery owner I have verified that the frees) 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 09- rson; then,'1 "agree to hold the City of
Clearwater harmless In any claim made for wrongful removal of such tree(s). .hereby cedtify,that this application to-
gether with any plans submitted is a true representation of all facts conce`rning the.proposed removai of the tree(s). Any
deviation fr the erm ed shall render if null -and vold and be consldered a vlolatiori ofChapter 52, Code of
Ordinanc
11VA Al
Signatur of own or pplicant .'`; r ^; ,, `� Punted Name`
Sri
�rz,`'•''� pit- Aof'-�'
Address %� „a,�fa, A 'Agency Representing (If No ner)
'' � . r In1jj•,b�,ja ' r r 1 F 1 r . S {y�'(_,'a' •y'x,} t3 • {.
_ 7 1 > � N • ` 1 `'"i`I � Y.`yy.� � � } ✓/C'r �. ” v , ''i'n 7.
City State . �" Zi ,:;Phone ;. ; 44 21 ,- -*��. ~
��
DO NOT WRITE BEL01MiHiS LINE `Not acid lfitii Signed By!City�M�an� ages or his`Deslgnated Agent
v
Inspector's Comme,pts:
Recommended Replacement Trees:
Required Replacement Trees:
Applicable Code Section:
Signed:
I for
y
yylfj
Date I
Based on the Inspector's comment; and information submitted, the above removal application is:
0 Approved as Submitted lq.Approved-Modified as Noted Above 0 Denied
`77) 11 r—� i C ! 1 Aa
Signed: Date:
'ty Manager D sign e
1 362.00;1 -GC 10-97
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2.
EXISTING FLOOR PLAN AND ELEVATIONS
t-- A I ZZ> I I N(�Z
= l5t�
I&
ZONING DISTRICT
O.L. ZONING
O.L. ZONING
PAVED VEPICULAR AREA
10,063 Sq. Ft.
11,151 5q� Ft.
-:z
BU ILDING
w
L OT
3
FIRST FLOOR PLAN
it
U54GE
MEDICAL OFFICE
MEDICAL OFFICE
LOT
PROPOSED ADDITION
16t FLOOR =
1,112 S.F.
OL
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0
BUILDING COVERAGE
4,04(o Sq, Ft.
5,2a3 Sq. Ft.
4.
EXTERIOR ELEVATIONS
LOT AREA
22,560 Sq. Ft.
22, tw
Sq Ft.
5.
FOUNDATION PLAN
&a. FT. AND ACRES
( 2 AC. )
( 0.52 AC. )
CONG.WAL<6
3E�O 6qW Fts
ro
ROOF FRAMING PLAN
TOTAL
1st FLOOR =
4,-le-1 &F,
0 LOT WI DTP 4
= 122. 4' x la3.50'
122.134' x 1 a3.50'
LOT DEFTP,
TOTAL IMPERVIOUS
14,4e�B &q� Ft.
I&Ala5q, Ft.
1,
BUILDING SECTIONS AND DETAILS
SUR!=AGE
(o4%
5
BUILDING 5ECTI & AND DETAILS,
IAA IN
2(o 5f=ACE5
PROVIDED
0 BUILDING COVERAGE
4 ,04(o Scj� Ft.
4,'lB'l 5q , Ft.
Sq. Ft.
4a(o 5a. FT, CARPORT
0 OPEN SPACE
Ci.
FIRST FLOOR ELECTRIC,41- PLAN
TOTAL FOR LOT
ajol 6q, Ft.
& e&5 Sq. Ft.
GRO65 FLO OR AREA
4 ,04ro Sq. Ft.
4,1: l .
1 '� Sq Ft,
,
10.
FIRST FLOOR REFLECTED CIELING PLAN
AND F. AR,
(21.0%
. PAR<IN G
Ll VA
FORMUL4
22 6f=ACE5
2ro SPACES
LANC)6CAFE LEGEND AND NUTi-;;;t5 ETBAC<
12 GENERAL NOTES AND SPECIFICATIONS FRONT
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101-011
4, -tel. F:t. o
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DATE
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