Schedule 'B' Application for Permit - Tree Removal/Alteration (2012)

Town of View Royal Application for Permit — Tree Removal/Alteration

Schedule "B" Application for Permit Pursuant to Section 14

Application/File No. __________

Please complete the following to help us process your application. This includes the written information on the front of this form and a sketch of the property where indicated. (If more room is required, please attach additional pages to this application form).

• Site Address: 212 SHAWN RIDGE PLACE V8Z-7Y2
• Name of Applicant: Judy Hasink
• Phone Number of Applicant: Day __________ Night __________
• Address of Applicant: __________
• Name of Owner (if different from above): __________
• Phone Number of Owner: Day __________ Night __________
• Address of Owner: SAME AS ABOVE
• Nature of proposed construction, if applicable: __________
• Related Permit(s) if applicable: __________
• Type and number of tree(s) proposed to be removed: __________
• Diameter of tree(s) proposed to be removed (determined by dividing the circumference of the trunk, measured at 1.2 m above the ground, by 3.142): 32" 74.5 cm DOUG FIR
• Type of proposed replacement trees: __________
• EMAIL: j.hasink@shaw.ca

Reason for removal (please circle the one item below that best describes your situation)

1. Too close to foundation
2. Too close to garage
3. Dead or dying
4. Unattractive
5. Too large for size of property
6. Blocking sunlight
7. Attracting wildlife
8. Causing sidewalk problems
9. Leaves causing problems
10. Blocking site access
11. Affecting house value
12. Hazardous
13. Interfering with utility wires
14. Interfering with water/sewer/drains
15. Interfering with view
16. Other __________

Supplementary documents may be required in support of this application and may include:

• a copy of a State of Title Certificate, or a copy of a Certificate of Indefeasible Title, dated no more than thirty (30) days prior to submission of the application
• a report prepared by an I.S.A. Certified Arborist, at the applicant's expense.

As owner or owner's agent, I have verified that the information contained within this document and associated applications and plans is correct. I acknowledge that responsibility for bylaw compliance rests with the owner and the owner's employees, agents and contractors. I will indemnify and save harmless the Town of View Royal, its officials, employees and agents against claims, liabilities and expenses of every kind, in respect of anything done or not done pursuant to this application or fact sheet or ensuing permit, including negligence and/or failure to observe all bylaws, conditions, acts or regulations.

Signed at View Royal, BC this __________ day of __________ year __________