900 GROVE STSEALM.
APPLICATION FOR LAND CLEARING & GRUBBING PERMIT
CITY OF CLEARWATER
TER. PLANNING & DEVELOPMENT SERVICES
One City. One Future. (727) 562 -4741 DATE �(
V
RECEIPT NO.
A non - refundable filing fee of $10.00 is required. Permit applicable for 6 months from date of approval
In accordance with the Community
property described below. //I
1. Location of Property: C'
2. Project Name: Ma 0 -
3. Purpose of clearing and /or grubbing:
Code, I hereby apply for permit to land clear and /or grub the
lap
New Construction ❑ Demolition ❑ Tank Removal ❑ Other
4, General description of existing vegetation, topography, and surface water (including all existing and /or proposed
ditches, canals, and swales)
5. Proposed method of debris at - -
6. Date you plan to begin work
7. Proposed method of soil erosic
8. '(No -Tree Verification Required ❑ Tree Removal Permit Required
I AM AWARE AND UNDERSTAND THE REQUIREMENTS OF SECTION 52.08, CITY CODE OF ORDINANCES REGARDING
TREE P ECTION D CONSTRUCTION AND ARTICLE 3, DIVISION 7 OF THE COMMUNITY DEVELOPMENT CODE
RE RDI G ER5n2±ND SILTATION CONTROL.
'lam /PiC
Sign ur f Owner or O s Representative Address
Printed Name city St Zip
rmzel
Repres nt fives, Firm
1.
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:
Based on the above comments and information submitted, the above clearing & grubbing application is:
XApproved As Submitted ❑ Approved - Modified As Noted Above ❑ Denied
Signed: Date: Z X00 (7
City Manager o esignee
CLEARWATER
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
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NO TREE VERIFICATION
o
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or
NO TREE REMOVAL PERMIT REQUIRED VERIFICATION STATEMENT
One City. one Future.
CITY OF CLEARWATER
PLANNING & DEVELOPMENT SERVICES
(727) 562 -4741
(Print or Type)
m
Owner: //i
j
L--?q
Phone:
3
Owner's Representative:
o
Phone:
Address of Applicant:
1
City: (f [ Gc
State: /�--� .4
Zip: ^7��
Location of Proposed construction:
9 (� i%� T%
Clearwater, Florida
r D
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
be use one of the following conditions exists:
ROTECTED 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 planubmitted with this�uest.)
PRINTED NAME:
SIGNED:
of Owner or Representative
Q 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:
SIGNED:
Owner or Representative
Signature of Owner or Representative
CLEARWATER
One City. One Future.
Brian J. Aungst, Mayor- Commissioner
Ed Hooper, Vice Mayor- Commissioner Bob Clark, Commissioner Ed Hart, Commissioner
J.B. Johnson, Commissioner
1430 0022 -GC White - Applicant Yellow - Planning & Development Services 8-99
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EXISTING PARK- —
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