1 of 3 9/2020
Natural Resources Permit Applicaon for
Subdivision & Site Development Projects
Property Informaon
Project Title (if applicable):
Address
Subdivision Name: Block: Lot:
Secon/Township/Range:
Direcons to property:
/ / Folio#:
Property Owner Informaon
Name: Dayme Phone:
Address: City/State/Zip:
Email: Fax Number:
Applicant Informaon
Name: Dayme Phone:
Address: City/State/Zip:
Email: Fax Number:
Person, Firm or Corporaon to physically conduct land alteraon/tree removal acvity
Name: Dayme Phone:
Address: City/State/Zip:
Email: Fax Number:
Natural Resources Informaon
The Owner or Authorized Agent hereby applies for a Permit for the purpose of performing the following acvity(ies).
(Mark as applicable):
o Tree Removal (number, trunk diameter, type):
o Grubbing (type of vegetation):
o Clearing (type of vegetation):
o Grading
o Excavating (cubic yards to be removed off-site):
o Filling (type, source and cubic yards):
o Required Landscaping:
Reason(s) for activity(ies) (Mark as applicable)
o Subdivision Infrastructure Development
o Subdivision Lot Development (Specify by Block and Lot)
o Commercial Project (e.g., multi family residential, mobile home park, office, retail, church, fire station, wastewater
treatment plant, industrial complex, etc.)
o Tree Transplanting (on a separate sheet, indicate the proposed transplanting methods)
o Unhealthy or Damaged Tree(s)
o Other (Specify):
Blanket Landscape Permit Requested?
o Yes o No (If not requested, proceed to zoning informaon.)
If yes, please complete the information requested on the next page. If you require additional rows for either section, you
may submit an Excel spreadsheet set up similar to the tables below containing all required information.
Subdivision Name: Phase:
