PB 24 06 PB Application

West Permit No: Date Issued, ORANGE * Township of West Orange - Application for Tree Removal and Replacement Permit ALL questions must be answered for the Applications to be considered COMPLETE. Application Date:__ 1/20/2774 This Application for a Tree Removal and Replacement Permit is made with reference to and the intent to comply with all applicable laws, rules, and regulations, including the General Revised Ordinances of the Township of West Orange. 1, Name of Applicant:_410 MAIN ST HOLDINGS LLC Street Address:_G Emma | ane City/State/Zip: Jackson, NJ 08527 Home Phone: Work/Cell Phone:_ (201) 883-1010 (attorney) Emait_ben@primelaw.com (attorney) 2. Location of Property Subject to Street Address:_410 Main Proposed Tree Removal Activity Street Block:_113 Lot: 262, 264 & 308 3. Property Owner(s) of Record Name of Owner__Same as Applicant Street Address: City/State/Zip: Home Phone, Worki/Cell Phone: Email, 4. Status of Applicant (Check One) —Tenant _X Owner __ Contract Purchaser Other: as “If the Applicant is not the owner, attach hereto the notarized consent of the owner.* 5. Has this property been the subject of an application and/or otherwise involved In a matter before the West Orange Planni ing Board and/or Board of Adjustment? YesX_ No__ , If yes, please state the dates and action taken or pending, identify the Township Agency who or is handling the matter, and enclose a copy of the resolution conserved by the mae if applicable:__ Pema 0, ho Cuce. id BAAS, Rac 6. Has the property received a construction permit and/or is there a construction permit pending? Yes__ NoX_ Ifyes, please the issuance of the permit: state the reason for and the date of application or the date of Trea Ramaval Application 4-13-15