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2. Date Submitted
3. Name
5. Homeowner Status

   1. I am the Homeowner
   2. *Non-Homeowner (Contractor/Builder/Representative/Other)
7. *Company if Builder/Contractor
8. Tree Removal Company
10. Phone
11. Email
13. Homeowner Property Address
15. Property Lot #
16. Block #
18. Signature (I certify I am the property owner)
20. Permit requested to move how many tree(s)
21. Tree(s) located by

    1. sidewalk/street
    2. driveway
    3. other yard location
22. Tree(s) located within 100 feet of the home foundation

    1. Yes
    2. No
24. Reason for requesting a removal permit

    1. Dead/Dying
    2. Public Hazard (rotted/falling branches)
    3. Construction
    4. Sidewalk
    5. Driveway
25. Describe the location of the tree(s) when facing the front of your house and reason for removal
27. Is this a Heritage Tree?

    1. Yes
    2. No
28. Are you willing to replace the tree?

    1. Yes
    2. No
29. Are you interested in the free Shade Tree Replacement Program?

    1. Yes
    2. No
Leave This Blank:


31. 1. Receive an email copy of this form.
32. Email address

    This field is not part of the form submission.

33. Submit

* indicates a required field