Fillable ABOUT IMMINENT THREAT TREE REMOVAL Code Reference Chapter (City of Sammamish)

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ABOUT IMMINENT THREAT TREE REMOVAL Code Reference Chapter (City of Sammamish)

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801 228
th
Ave NE
Sammamish, WA 98019
425-295-0500 | www.sammamish.us
2020-01-ITTR Page 1 of 3
IMMINENT THREAT TREE
REMOVAL NOTIFICATION FORM
ABOUT IMMINENT THREAT TREE REMOVAL
Code Reference
Development Standards - Trees
Chapter 21A.37 SMC
Resources
Tree Management Webpage
Find a Certified Arborist
King County iMap
Sammamish Property Tool
Questions?
Email the Tree Removal team
City of Sammamish
801 228th Ave SE
Sammamish, WA 98075
www.sammamish.us
Property owners can remove significant trees if there is an emergency and
the tree may cause serious/life-threatening injury or death.
Thi
s form is designed to be completed by property owners that have
already removed a significant tree.
APPLICATION REVIEW PROCESS
Once you submit the Imminent Threat Tree Removal Notification Form and
accompanying documentation, it will be reviewed by staff to determine if
the tree removal qualified as an imminent threat.
I
f everything looks okay, then the City will provide a receipt of
confirmation. Please see MyBuildingPermit.com for current processing
times.
If the condition that prompted the removal does not qualify as an
imminent threat, staff will contact you to discuss next steps which will
include a retroactive permit for significant tree removal and/or the tree
removal actions being subject to Code Enforcement.
FEES
There are no fees for imminent threat tree removal.
2020-01-ITTR Page 2 of 3
IMMINENT THREAT TREE
REMOVAL NOTIFICATION FORM
1
4
3
2
OWNER INFORMATION
Name:
Address:
Phone:
E-Mail:
APPLICANT/REPRESENTATIVE INFORMATION
Name:
Address:
Phone:
E-Mail:
PROPERTY INFORMATION
Property Address:
Parcel Number(s):
SUBMITTAL CHECKLIST
A PDF of each document is required at time of submittal. Please label files as numbered and listed below:
(For example: 02 Site Plan)
☐ 01. Signed City Application Form (including the Imminent Threat Tree Affidavit on page 3)
− Affidavit must be signed within 21 days of tree removal
☐ 02. Site Plan (see example)
− Provide a basic sketch showing the location of tree(s) removed and location of replacement trees
☐ 03. Photographs
− Provide photos of the tree and the threatening condition
ONLINE SUBMITTAL INSTRUCTIONS
Create an account on MyBuildingPermit.com.
Select “Apply For Permit” and then select “Sammamish” as the jurisdiction.
Select the following:
Application Type
Clearing & Grading
Project Type
Any Project Type
Activity Type
Trees or Vegetation Only
Scope of Work
Tree Removal Notification
Complete & save this form before uploading it in the “File Upload” section along with the required
submittal documents.
2020-01-ITTR Page 3 of 3
IMMINENT THREAT TREE
REMOVAL NOTIFICATION FORM
date
time
Condition that prompted removal
IMMINENT THREAT TREE AFFIDAVIT
NO notary is required for this affidavit.
The
undersigned, being first duly sworn on oath deposes and says:
A. I am over the age of eighteen (18) years and competent to be a witness herein.
B
. I am the property owner of ____________________________________________________
in Sammamish, Washington.
C. On _________________________ at _________, I removed ________ tree(s) due to
______________________________________________________________________.
D. To the best of my knowledge:
☐
The conditions that prompted the removal constitute an emergency and emergency
action was required.
☐
The date, time, and conditions of removal listed above and, in the photos, provided
with this form are accurate and true.
☐
A replanting plan has been provided with the site plan that meets the requirements
of SMC 21A.37.280.
E. I w
ill be planting ___________ tree(s) to replace the __________ tree(s) removed.
F. I understand that the statements above will be verified in order for a permit exemption
under SMC 21A.37.230 to be issued and that tree removal in violation of the City’s tree
preservation standards is considered a criminal misdemeanor.
I c
ertify (or declare) under penalty of perjury under the laws of the State of Washington that the
foregoing is true and correct.
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Date:
Place:
(City and State)
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ABOUT IMMINENT THREAT TREE REMOVAL Code Reference Chapter (City of Sammamish)

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Completed 26 February 2021

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