Tree Removal and Replacement Application 104 Winding Way

Permit No: Date Issued: 7. Describe or attach the landscaping replacement planting plan, If applicable, including the number, size and species of trees to be teplaced. Attach additional sheets if necessary: 8. Describe or attach grading Plan if more than six (6) inches of soil will be removed or added within the drip line of a tree or trees on the site: 9, Map, drawing or diagram must be attached hereto. List the names, address, phone number J and email of the preparer of the map drawing or diagram attached: 7 10. List the number, species, and diameter of each tree to be removed: 11, State reason for tree removal: « 12. Identity contractor who will be providing tree removal services: Name: Address: City/State/Zip: Work Phone:. Cell Phone: Email: 13. Proposed dated to commence tree removal: Proposed dated to complete tree removal: Itis understood that the undersigned may be subject to statutory penalties for each violation of the terms and conditions of the West Orange Tree Preservation, Removal and Replacement Ordinance. The undersigned agrees to post a Copy of the Tree Removal Permit on the site and to Present a copy for review upon request. SS Mune l Gituea /ol XL / ay Applicant's Signature Print Name Legibly Date Tree Removal Application 4-19-15