Fillable LCEXP-2 Land Clearing Permit Exemption Request LCEXP-2_Land_Clearing _Permit_Exemption_Request

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LCEXP-2 Land Clearing Permit Exemption Request LCEXP-2_Land_Clearing _Permit_Exemption_Request

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FORM: LCEXP-2
CITY OF LACEY
Community Development Department
420 College Street SE
Lacey, WA 98503
(360) 491-5642
LAND CLEARING PERMIT
EXEMPTION REQUEST
Name: ____________________________________________________
Address: __________________________________________________
Phone: ____________________________________________________
Contractor: ________________________________________________
Number of trees to be removed: _________ Number of existing trees: _________
(Cannot exceed five trees in 36 months)
Size of lot: _________________________
Please draw your site plan below, indicating your home and the location/type of trees to be removed:
OFFICIAL USE ONLY
Case Number: ___________
Date Received: __________
By: ___________________
Parcel Number:
_______________________
Permit Issued: ___________
Required Replanting: _____
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LCEXP-2 Land Clearing Permit Exemption Request LCEXP-2_Land_Clearing _Permit_Exemption_Request

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Completed 13 July 2020

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