Application 6 12 25

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 replaced. Attach additional sheets if necessary:_to be provided 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: to be provided if trees are to ‘be femoved 8. Map, drawing or diagram must be attached hereto. List the names, address, phone number # and email of the Preparer of the map drawing or Giasram attached: to be provided if trees are to be remove: 10. List the number, species, and diameter of each free to bi removed, to be provided if trees are {D8 Yemoved 11. State reason for tree removal: 1 er abe prota deed tae renioned Name: Address; City/State/Zip: Work Phone: Cell Phone: Email: 13. Proposed dated to commence tree removal: Proposed dated to complete tree temoval: itis understood that the undersigned may be subject fo 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, easho, SHoid gous Weathes Godse 6-t-aS Applicant's Signature Print Name Legibly Date PALO, ia f xX ak Chea Gracddne Ahiart Socolos Tree Removal Application 4-13-15