1802 BELCHER RD NCITY OF CLEARWATER - PLANNING & DEVELOPMENT SERVICES
TREE REMOVAL PERMIT
�.
NAME OF OWNER CAIA I J. IS, JaMeT C- Jz, tq '- -t'r -461FZ2
OWNER'SADDRESS 2,62k- VA61TLE L-A'ti C"14— 3)ki
PHONE 77-7 al- ^ ✓c; 70
SITE ADDRESS 07—
LOCATION OF TREE(S) ON LOT Z� v
SPECIES AND NUMBER OF TREE(S)
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.
C ASON FOR REMOVAL:
onstruction
• Permit # 1
• See "A" below
❑ Hazardous
• Declining
• Dead
• Other (Specify)
Fee Rec'd. $
Receipt # —
A) CONSTRUCTION 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 f. Proposed Number of Parking Spaces j. All Protected Trees Including:
b. Structure Locations g. Proposed Underground Utilities (i.) Diameter of 4.5' above grade (DBH)
c, Driveways and Walks h. Zoning Setbacks (ii.) Surveyed Location
d. Parking Arrangement I. All easements and Rights -of -Way (iii.) Species
e. Required Number of Parking Spaces (iv.) 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: 12' overall height, 4" caliper, 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 tree representation of all facts concerning the proposed removal of the tree(s). Any deviation
from permit i suue�d shall render it null and void and be considered a violation of the Community bevelopment Code.
Signci a of owner or applicant Printed Name
Address
C LEA � 44/1KT eg-
City State Zip
DO NOT WRITE BELOW THIS LINE - Not Valid Until
AMT•CV1 c,'r c
Agency Representing OCL #
711 'S� � � 77-7 1-7Z,6 - 071 �
Phone Fax
ned By City Manager or his Designated Agent
Z
O
(
Applicable Code Section: ��
Based on the Inspector's comments and information submitted, the above removal application is:
Approved as Submitted pproved- Modified as Noted Above ❑ Denied
1
Signed: Date: 4)2_ Community velopment�Coordinator or Designee /Inspector Valid for six months from the date of issuance.
1362.0001 -GC White - Planning & Development Services Yellow - Applicant Rev. 4 -01
!ii
;.
r r
� r
;t
r
E
��` t
BUFFER AT 110111 RESIDENTIAL
I TRj
5' LVIDE, I TREE:/3y I too,
tie
0 C, SILI D U S 2 * G SE N1 E R%, A-L 0 AFF F I C E
A— I
77
1p T
Z0'NjllNlG: iRl
r
-C TO
BUFFER AT ARTEIRIAL OR MAJOR COILLE TO R
3:
.17509
u
3:
I" <
_7
ui
m
--!-799
ul
ca
SETit`:-!ACKS(RE0'D UNDER IRT): FRONT,
20" REAR
15'
PAVED AREA
10,763 S-f-
m
AROUND SIGN POST
ul
1-Ai"-JDSCAj::�E At'REA
12,293 s-f-
-- ------- -
PLANT' MAI-ERIAL
SCHEDULE
vi
z
MARK 'BOTANICAL NAME
COMMON NAME
SPECFCAT011
SIZE OTY
vs V BURNUN SUSPENSUM
V BURNUM 5ANDANKWA
2'
H IGH
GALLON 15
3 '
QV OLIERCUS VIRGINIANA
LIVE OAK
E
L B 4' CAL
R2' HIGH I
Ri 'RAPHIOLEPIS INDICA
INDIAN HAWTHORN
2'
HIGH
3 GALL ,ON-53--,
PA PL03AG4 ARICULATA
CAPE PLUMBAGO
2'
WGH
H LAGERSTROEMIA IIDCA
CRAPE-MYRTLE
30
GAL 3' CAL
6 H- GH
0 5 is 3s
EEEHEE���
'30
GAL MULTI 5TEM
?
Tip...
TAXOD!Ull DISTICHUM
i BALD CYPRESS
B
I B I" CAL
HIGH
5 LIX BABYLON !CA
WEEPING W111.1-OW
B
I B 4' CAL
8' HIGH
SOD SAMD GROWN ST. AU GUS TINE
----------
MULCH SHREDDED RED TREATED
CYPRESS 3' THICK IN ALL
PLANTING
AREAS
IRRIGA'TON 5"T'STEM
TREE REMOVAL DAT11%
TOTAL 51,
i
Ci
SC
L'TH COMPATIBLE PLANTS/SHRUBS
50 AS TO COMPLY MIT H LANDSCAPE
io
REGITREMENTS
NELI S' ONC SIDEUALK
--- --- . .....
51 ItITY
TRIANGLE
N OR T H
r
-C TO
BUFFER AT ARTEIRIAL OR MAJOR COILLE TO R
3:
U 5 5
MIN 15' ODE I TREE/35' t 100"'3' S11' '5
u
3:
I" <
_7
ui
m
<1= BELCHER ROAD
ul
ca
- C3
ui
�
7,
OW CONCRETE SUR ROUTE D
C)
m
AROUND SIGN POST
ul
Ln
-- ------- -
vi
z
Ll
"I
PROVIDE ONE 5!GN PER HANDICAP STALL
Y,
-r Y P HANDICAP SIGN
ai
"GALE: 3/4' 4-0`
-E&ANDSCAPE PLAN
Sit
SCALE 1'=20'
0 5 is 3s
EEEHEE���
?
0 10 20
GRAPHIC SCALE
N OR T H
r
lu
3:
u
3:
L
ui
m
ul
ca
- C3
ui
�
kg
C)
m
LIJ
ul
Ln
vi
z
Ll
"I
Y,
r
3:
u
L
ui
m
ul
ca
- C3
ui
�
kg
C)
L;01
UJI
3:
u
ui
m
ul
<
ui
�
0
C)
LIJ
z
V)
2-23-02
13
/— NOrtI760`51 Comer of Lot I
Clecrwcter Industricl Pork, Reclat
Plot Sook 44, Pg. 46
NO, I C' T
DATE
Is
SE Correr of the IVE. 11'4 — Of the
SE 114 of Section 1-2.9-15
RUTZ OFFICE BUILDING
SUNNYDALE DRIVE & BEL R ROAD
CLEARWATER , FLORIDA
E XI ST S I
M PLA, I t
D
9
C-2 I