1020 DRUID RD�?S`•~ CITY OF CLEARWATER - PLANNING & DEVELOPMENT SERVICES
TREE REMOVAL APPLICATION FORM Nn 4087
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One City. One Future.
NAME OF OWNER: (2tC Kl S I _
f dJ6 Fee Rec. S
Date Re
SITE ADDRESS: 102 0 TRu I h Rec. By: _B
Clearwater, FL Rec't #
REQUIRED REPLACEMENT TREES
-
TREE REMOVAL PERMIT N2 4087
NAME OF OWNER 16ARS6,104
OWNER'S ADDRESS i q9 s l.A6c� -V 1S-tA 3i. v 2> . '9ALM NA£!
PHONE - 7 7S 7 4 o,4 c�;, 34&
SITE ADDRESS I C7 ZO -T)V U I D C Lr�Ag wAiEfL_ Pf
LOCATION OF TREE(S) ON LOT As st- w,4
SPECIES AND NUMBER OF TREE(S) %gs I_AUP-C-L oA ks;
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.
A) CONSTRUCTION
1. For new construction, additions or other modifications
a site plan is required. This site plan must have.a minimurr
site plan must include:
a. Major Changes of Grade
b. Structure Locations
c, Driveways and Walks
d. Parking Arrangement
e. Required Number of Parking Sr
f. Proposed Number of Parking SI
g. Proposed Underground. Utilities
h. Zoning Setbacks
2. Protective barriers are required ar
intact during construction. The barrier
B) REPLACEMENTS
1. Tree replacement minimum static
determine the number of replacerne1
I hereby certify that as property.- own0
to be removed is wholly on property;
the tree(s) are located wholly or'parf
Clearwater harmless in any claim mad
with apfplans submitted' true repre
frorr/fh666ermit wed all render.itnt
Signature oyier -®r applicant
2_4 OSAi.7djN
Address
5
City State
DO NOT
REASON FOR REMOVAL:
❑ Constructio
•Permit #oil- llrf`�
-See "A" below
❑ Hazardous
❑ Declining
❑ Dead
10 Other (Specify)
trtv�llnh houac - bV114nCAJ
Fee Rec'd. $
Receipt # (AWI
Date -x x -00
which involve the removal of a protected tree(s),
O':;for,single family lots, or 1 " =50' for all others. The
r All easements and Rights -of -Way
j AN.Protected Trees Including:
)rarneter of 4.5' above grade (DBH)
(ri.): "Surveyed Location
or Insect Infested Trees
Removed
Detail & Locations
ese barricades must remain.
inspectors note below to
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Q
Do
that the tree(s) sought
it be determined that
.ee to hold the City of
is application together .
tree(s). Any deviation
V Development Code.
iLz:, T vv, 6 Cr 1*afe �,,.Sf .
6-7o-,_
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Required Replacement Trees:
Applicable Code Section: 3 -° ) ?o�
Based on the Inspector's comments and information submitted, the above removal application is:
❑ Approved as Submitted Approved- Modified as Noted Above ❑ Denied
1
Signed: Date: a(co
Cit Manager or Designee /Inspector
CLEARWATER
One Citu One Future
Brian J. Aungst, Mayor- Commissioner
Ed Hooper, Vice Mayor- Commissioner Bob Clark, Commissioner
Ed Hart, Commissioner J.B. Johnson, Commissioner
1 RAO r)nn1 _G(` 1A /hit.. 4nnNrnn4 VcIIn4Y- Dlnrinlnn k flouclnnmcn} Ccniircc
.� gill CITY OF CLEARWUATER
rwater
PLANNING & DEVELOPMENT SERVICES
100 South Myrtle Avenue; Clearwater, FL 33756 p.
562 -4567
PERMIT NO, Z001 f
ADDRESS looms -
.CORRECTION NOTICE
TIME: r�
fi 'ON / / I INSPECTED THIS STRUCTURE AND
THESE PREMISES AND HAVE FOUND THE FOLLOWING VIOLATIONS OF
THE CITY OF CLEARWATER CODES. --~`
REINSPECTION FEE: , AMT. $`
00
41 ,
Please make corrections within 15 days and call 562 -4580 for reinspection. If
inspection not requested within time limit, you are subject to additional fees.
All fees to be paid before reinspection."
INSPECTOR Phone 562 -456
DO NO RENIOV HIS AG
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1430 0001 - .Rev. 4 -01 .
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Brian J. Aungs ayor -C m er�//////InnI
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Hoyt Hamilton, Commissioner n� ,, Commissic
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