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3030 MCMULLEN BOOTH RDAPPLICATI4N FOR LAND CLEARING & GRUBBING PERMIT CITY OF CLEARWATER PUBLIC WORKS DEPARTMENT ENVIRONMENTALMANAGEMENT (813) 462-6747 DATE RECEIPT NO. A non-refundable filing fee of $10.00 is required per Resolution 86-9. Permit applicable for 6 months from date of approval. In accordance with Section 98.30, I hereby apply for permit to land clear and/or grub the property described below. 1. Location of Property �'� �" ! � � 2. Project Name 3. Purpose of clearing and/or grubbing 4. General description of existing vegetation, topography, and surface water (including all existing and/or proposed c�itches, canals, and swales) 5. Proposed method of debris disposal � 6. Date you plan to begin work � � f��_ 7. Proposed method of soil erosion control 8. ❑ No-Tree Verification Required C;�l'"Tree Removal Permit Required -,,.--, I AM AWARE AND UNDERSTAND THE REQUIREMENTS OF SECTION 98, CITY CODE OF ORDINANCES REGARDING TREE PROTECTION DURING CONSTRUCTION AND HAVE READ CITY'S EROSION AND SILTATION CONTROL POLICY . , � Subscribed and Sworn before me !�� • Signature of Owner or Owners Representative �� '{ . . this � - day of � �',�• 1 � �4.� . , . ._, . , x • '� �",_- �,./�;:� _ �- ,; . Printed Name '�� ' I � ,�' %��' r' ��/ � Signature of Notary .n'' Address ' �� . �C�� . --� �-> NAME OF NOTARY % !, � -` J j- �,. ` City State� Zip COUNTY � � - � "' � '�'`'�% COMMISSION EXPIRES �!+�'� p+��tc ��ir.ti�� +� F'3a�� Representatives' Firm `J Telephone yy �,t�� ^ `.' ' ' 4�Dv l�iMly[�t) 'Ti�kl i.�lGS±"r,i;ww. (lh;.- l�ii�1�. Applicant must include Aerial Photograph or Scaled Drawing showing property boundaries and limits of work. This is NOT a Tree Removal Permit. DO NOT WRITE BELOW THIS LINE Comments , ¢ { >>r i " , , __ . �_ I � � , • i �l ;�e, � . � �>./,:� � ��,.,-,� 1 �� ,., _ l �r ,,. �, ��7��,. . .- : , s l , .. , �� . Comments �� -/;� . . � . � � �- _ i` , ._ , l _ Water Resource Spec Urban Forester Based on the above comments and information submitted, the above removal application is: ❑ Approved As Submitted C� " Approved — Modified As Noted Above ,_ Signed: � A' � ---' � _ Date: .. City Manager or Designee White — Applicant Yellow — Environmental Pink — Inspector Date Date ❑ Denied Rev. 9/87 I APPLICATION FOR LAND CLEARING & GRUBBING PERMIT CITY OF CLEARWATER PUBLIC WORKS DEPARTMENT ENVIRONMENTAL MANAGEMENT (813) 462-6747 DATE /� , � RECEIPT NO. A non-refundable filing fee of $10.00 is required per Resolution 86-9. Permit applicable for 6 months from date of approval. In accordance with Section 98.30, I hereby apply for permit to land clear and/or grub the property described below. 1. Location of Property '? ;� , ,a . � ,,'��--;f: , .=�" :- '� 2. Project Name �fl��s� � �_� �/r_ �' �I � ��'"��' ��. � � - ., � i . i � ,/� r , 3. Purpose of clearing and/or grubbing �fi.� � . - ,� - �� - 4. General description of existing vegetation, topography, and surface water (including all existing and/or proposed ditches, canals, and swales) - -. �, � : j � � , �-. � � . � , _ .. _ _ 'y l�.//�} . �t'�i..r'C' _I: " _ . , ,..1- _ � - 5. Proposed method of debris disposal -� ��- `l�' �r-�.- , 6. Date you plan to begin work 7. Proposed method of soil erosion control �� E � i' F- � � � 8. ❑ No-Tree Verification Required 17.TYee Removal Permit Required I AM AWARE AND UNDERSTAND THE REQUIREMENTS OF SECTION 98, CITY CODE OF ORDINANCES REGARDING TREE PROTECTION DURING CONSTRUCTION AND HAVE READ CITY'S EROSION AND SILTATION CONTROL RQLICY j ~�/ .� Signature of Owner or Owners Representative , . �I Subscribed and Swom before me �`' ' J , •�'• this day of �-z. ��' , 19 i Printed Name ,�fY ,' p`�`: . Signature of Notary Address NAME OF NOTARY City �, �� . State zip COUNTY _ ' ; ^u x.:; t�!_t� � tnz� �" r�,�,��.x`, ; r / � f`_ ,', ,� COMMISSION EXPIR�S�,,�,,�„r�•, r°x�. �c,,, �, �+.; Representatives' Firm Telephone ��Kr•r:�� rnkt� .f:y�`:.��, �:•��:. !��+� . Applicant must include Aerial Photograph or Scaled Drawing showing property boundari s and limits of work. This is NOT a Tree Removal Permit. ,��_ ' � DO NOT WRITE BELOW THIS LINE �``�.. �� ` ``r��' f�"��"�''�� o"/� Comments _ Comments ,�. , r Water Resource Spec Urban Forester Based on the above comments and information submitted, the above removal application is: f� Approved As Submitted ❑ Approved — Modified As Noted Above Signed: City Manager or Designee Date: White — Applicant Yellow — Environmental Pink — Inspector Date Date ❑ Denied Rev. 9/87 APPLICATION FOR LAND CLEARING & GRUBBING PERMIT CITY OF CLEARWATER PUBLIC WORKS DEPARTMENT ENVIRONMENTAL MANAGEMENT (813) 462-6747 DATE RECEIPT NO. A.non-refundable filing fee of $10.00 is required per Resolution 86-9. Permit applicable for 6 months from date of approval. In accordance with Section 98.30, I hereby apply for permit to land clear and/or grub the property described below. 1. Location of Property ':} 2. Project Name �� - '�ue� Go1 f cot�rse 3. Purpose of clearing and/or grubbing �<z� .r�� }- - •c � �� E � � ` � 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 disposal �ut�,m, -rt�f; 6. Date you plan to begin work I�ti��vc�i'ii>�� 28th 19�:'� 7. Proposed method of soil erosion control ��5 :;ubrli�t�c �� <� � � �� :� � 8. ❑ No-Tree Verification Required � Tree Removal Permit Required I AM AWARE AND UNDERSTAND THE REQUIREMENTS OF SECTION 98, CITY CODE OF ORDINANCES REGARDING TREE PROTECTION DURING CONSTRUCTION AND HAVE READ CITY'S EROSION AND SILTATION CONTROL POLICY � � � � t . G'�- J�. �, , � '� �` �`- ''L:-f= ' � `'�"'� �''�"'""'" Subscribed and Swom before me C� - .' , Sigrratuce of 0.�eroor �wner'_s Representative _ : -- - — � � : c- this—�day of ,n/l ��l'"/�/11=��"/. 19 ` Printed Nariye � f +� +°,.G,�r � � . t _�,�` � . Z,,C.,!�',! : � �/,�� >r�• oUY'�'��'t��'F'�t. � Signature of Notary L Address '� r ' ' NAME OF NOTARY t�;.� '`�f�f= � ; ,`>. L;rc�a�er, '��a 3-k ._ _ City + Ro�;�,.-��uSt�at�,e zip COUNTY '' '�t. S Cl�a r,• , . ,:,� ..�� c �, : �.�-ion : � --�;;;,,;; COMMISSION EXPIRES CG�aj r,,�� Representatives' Firm Telephone Applicant must include Aerial Photograph or Scaled Drawing showing property boundaries and limits of work. This is NOT a Tree Removal Permit. Comments Comments .` . � DO NOT WRITE BELOW THIS LINE �,, Water Resource Spec Date Urban Forester Date Based on the above comments and information submitted, the above removal application is: C� Approved As Submitted LJ Approved — Modified As Noted Above ❑ Denied Signed: —. City Manager or Designee Date: Rev. 9/87 While — Applicant Yellow — Environmental Pink — Inspector