Executed Tree Removal and Replacement Application submission

Permit No: Date Issued: WEST 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: x t ae 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_Mavis Tire Supply, LLC (atin: James Micik, Director of Entitlements) Street Address: 100 Hillside Avenue City/State/Zip:_White Plains, NY 10603 Home Phone: Work/Cell Phone:_914-984-2500 x5213 Emait_jmicik@mavis.com ?. Location of Property Subject to Proposed Tree Removal Activity Street Address: 460 Prospect Avenue Block:_105. tot:_ 64.04 3. Property Owner(s) of Record Name of Owner_460 Prospect Street, LLC (attn: Cheri Bungard) Street Address:_1625 Route 10 City/State/Zip:_Morris Plains, NJ 07950 Home Phone:, Work/Cell Phone:_973-490-8209 Email:_cbungard@weichertdevelopment.com 4. Status of Applicant (Check One) Tenant __ Owner _v Contract Purchaser __ Other: *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 Planning Board and/or Board of Adjustment? Yes__ No___ Ifyes, 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 Agency, if applicable: 6. Has the property received a construction permit and/or is there a construction permit pending? Yes__ Nov__ If yes, please state the reason for and the date of application or the date of the issuance of the permit: ‘Tree Removal Application 4-13-15