TOWN OF LAUDERDALE-BY-THE-SEA, FLORIDA
DEVELOPMENT SERVICES DEPARTMENT
4501 N. Ocean Dr. LBTS, FL 33308
Ph (954) 640-4210 / Fax (954) 634-4654
LANDSCAPE PERMIT APPLICATION
FOLIO
#
ZONE
LOT
BLOCK
SUBDI
VISI
ON:
ADDRESS
OF
JOB
SIT
E:
PROPERTY OWNER:
NAME:
ADDRESS:
C
I
TY:
ZIP CODE
PHONE
#
E-MA
I
L
PROPERTY OWNER OCCUPIED: YES
NO
NAME OF CONTRACTING
F
I
RM:
ADDRESS:
C
I
TY:
ZIP
CODE
PHONE
# E-MAIL
LICENSE
#
INSURANCE
#
Single
or
Multi-family
dwe
lling:
Square
Footage
of
Property:
Total
number
of
Existing
Trees:
Total
number
of
Existing
Shrubs:
Tree removal ( ) Tree relocation ( ) Dead Tree Removal ( ) New Landscaping ( )
Total
number
of
trees
being
removed/relocated:
Total
number
of
trees
planted:
Proposed
commencement
date:
Proposed
completion
date:
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
Application is hereby made to obtain a permit to do work and installation as indicated. I certify that no work or installation has
commenced prior to the issuance of a permit and all work will be performed to meet the standards of all laws regulating work within
this jurisdiction.
OWNER’S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all
applicable laws regulating construction and zoning.
NOTICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that may be
found in the public records of the Town or County, and there may be additional permits required from other governmental entities.
DATE
Signature (Building Owner) Signature (Contractor)
DATE
Printed Name Printed Name
NOTARY DATE
NOTARY DATE
My Commission Expires My Commission Expires
**Single Family/Duplex - $30 Multi-Family - $50 plus $250 deposit**
