Application for Permit - Tree Removal/Alteration and Property Sketch

Schedule "B"

Application for Permit

Pursuant to Section 14

Application/File No. 2016-06

Town of View Royal

Application for Permit - Tree Removal/Alteration

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: 18 Amber Pl View Royal BC V9A 1Z5
• Name of Applicant: Cole Ryan Daugherty
• Phone Number of Applicant: Day: [Blank] Night: [Blank]
• Address of Applicant: 18 Amber Pl
• Name of Owner (if different from above): [Blank]
• Phone Number of Owner: Day: [Blank] Night: [Blank]
• Address of Owner: 18 Amber Pl View Royal B.C V9A 135
• Nature of proposed construction, if applicable: [Blank]
• Related Permit(s) if applicable: [Blank]
• Type and number of tree(s) proposed to be removed: removal of 1 maple tree in front yard
• 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): approx 3ft diameter
• Type of proposed replacement trees: CHERRY

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 (circled)
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 [Blank]

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 21st day of January year 2016

Property Sketch

Site Address: 18 Amber Pl

Your property sketch must include:

• The dimensions of the property and location of the street(s)
• The location of the house and other buildings on the property
• The exact location and type of trees that you wish to remove
• The planting location and type of replacement tree
• The location and types of all other trees on the property
• The type and location of proposed construction activities, including accesses, if applicable