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SECTION 1 (City of Rollingwood)

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BROWSE CITY OF ROLLINGWOOD (TX) FORMS

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CITY OF ROLLINGWOOD TREE REMOVAL PERMIT APPLICATION
1
TREE REMOVAL
PERMIT APPLICATION
SECTION 1
PROPERTY OWNER
Property Owner _________________________________________________________________
Mailing Address_________________________________________________________________
Email _________________________________________________________________________
Phone_________________________________________________________________________
Type of Property: Residential Public property, right of way, public easement Other
APPLICANT INFORMATION
Applicant (check box and skip this section if the Applicant is also the property owner)
contractor/arborist property manager other authorized representative
Name _____________________________ Company __________________________________
Mailing Address_________________________________________________________________
Email _________________________________________________________________________
Phone_________________________________________________________________________
License Type & Number (if applicable)________________________________________________
TREE REMOVAL SERVICE PROVIDER
Applicant City Registered tree removal permit holder _____________________________
REPLACEMENT TREE PLANTING SERVICE PROVIDER
Applicant Landscaper or other _______________________________________________
CHECK ONE PERMIT TYPE BELOW
SECTION 2
STANDARD TREE REMOVAL & REPLANTING PERMIT APPLICATION
I am applying for a standard Tree Removal Permit Application
EMERGENCY TREE WORK/RETROACTIVE PERMIT APPLICATION
I had to remove the tree(s) and/or portion of tree(s) because the actively failing condition and
location(s) and/or portion of the tree(s) presented such a clear and present immediate danger to
structures or to the health and safety of the public that there was insufficient time to obtain a tree
permit. I am submitting this application within 7 days of the work in order to receive a retroactive
Tree Permit. I have included photographic evidence or other documentation of the hazardous
portion(s) of the tree(s) of the clear and immediate danger that created the emergency. NOTE- The
property owner or authorized representative and/or tree care provider may be found in violation of
City code if it is determined that regulated trees were removed without a permit and the
owner/applicant is unable to demonstrate the emergency.
INTERNAL USE – DATE RECEIVED ________ REC BY _____ #______ TO ARB _______
CITY OF ROLLINGWOOD TREE REMOVAL PERMIT APPLICATION
2
TREE IDENTIFICATION AND PLAN
SECTION 3
TREE INFORMATION – Mark the trees identified in this application with ribbon for identification
Total # trees requested for removal: _________ Color/Type of ribbon:________________________
For the trees identified below, please include a photo showing the circumference measurement
around the trunk at 4.5 feet above the ground of each protected tree.
Attach additional copies of this page as needed for additional trees
(A) Fill out the following table identifying each protected tree in the following locations, and
each required replacement tree:
- PROTECTED TREES within residential “BUILDABLE SPACE” (located OUTSIDE a setback
having a width greater than 10 ft); OR
-
PROTECTED TREES within PUBLIC PROPERTY, RIGHT OF WAY, OR PUBLIC EASEMENT
#
PROTECTED
TREE LIST
SPECIES
REASON FOR
REMOVAL
(A)
LANDSCAPE;OR
(B)
DEAD/DYING/
DANGEROUS
PROPOSED REPLACEMENT TREE
SPECIES
= 1 TREE, BASED ON REPLANTING
LOCATION, FROM
(A
) THE PROTECTED TREE LIST; OR
(B
) THE 20FT TREE LIST (APPLICABLE
IF PLANTEED WITHIN 20 FT OF ABOVE-
GROUND UTILITY LINE)
REPLACEMENT TREE SIZE
(A) PROTECTED TREE
DIAMETER (CAP AT 6 IN) =
.25 * PROTECTED TREE
DIAMET
ER
(B) 20 FT TREE = 8 FT TALL
(OR COMP)
A1
A2
A3
A4
A5
A6
A7
A8
CAPPED
(SEE NOTE A BELOW)
A9
CAPPED
-
A10
CAPPED
-
(B) Fill out the following table identifying each protected tree in the following locations, and
each required replacement tree:
- PROTECTED TREES within residential “GREEN SPACE” (located WITHIN a setback having a
width greater than 10 ft); OR
#
PROTECTED
TREE LIST
SPECIES
TRUNK
DIAMETER
(INCHES)
=
CIRC/3.14
REASON FOR
REMOVAL
(A)
LANDSCAPE;OR
(B)
DEAD/DYING/
DANGEROUS
(SEE NOTE B
BELOW)
PROPOSED REPLACEMENT TREE
SPECIES
= 3 TREES, BASED ON REPLANTING
LOCATION:
(A
) AT LEAST 1 FROM THE PROTECTED
TREE LIST; AND
(B
) AT MOST 2 FROM THE 20FT TREE
LIST (APPLICABLE IF PLANTED WITHIN
20 FT OF ABOVE-GROUND UTILIT
Y
LINE)
REPLACEMENT TREE SIZE
(A) PROTECTED TREE
DIAMETER (CAP AT 6 IN) =
.25 * PROTECTED TREE
DIAMET
ER
(B) 20 FT TREE = 8 FT TALL
(OR COMP)
B1a
B1b
B1c
B2a
B2b
B2c
B3a
B3b
B3c
B4a
B4b
B4c
CITY OF ROLLINGWOOD TREE REMOVAL PERMIT APPLICATION
3
PROTECTED TREE LIST
(FOR REMOVAL AND REPLANTING)
- ASH, TEXAS
- CYPRESS, BALD
- ELM, AMERICAN
- ELM, CEDAR
- MADRONE, TEXAS
- MAPLE, BIGTOOTH
- ALL OAKS
- PECAN
- WALNUT, ARIZONA
- WALNUT, EASTERN BLACK
20 FT TREE LIST (FOR REPLANTING WITHIN 20 FT
OF ABOVE-GROUND UTILITY LINE)
- ANACACHO ORCHID TREE
- COMMON TREE SENNA
- CRAPE MYRTLE (DWARF)
- DESERT WILLOW
- EVERGREEN SUMAC
- EVE’S NECKLACE
- FLAMELEAF SUMAC
- GOLDENBALL LEADTREE
- MEXICAN BUCKEYE
- MEXICAN PLUM
- POSSUMHAW HOLLY
- ROUGH LEAF DOGWOOD
- TEXAS MOUNTAIN LAUREL
- TEXAS PERSIMMON
- TEXAS PISTACHE
- TEXAS REDBUD
- WAX MYRTLE
- YAUPON HOLLY
NOTE A – If more than 7 protected trees are listed under section 3(A) and the replacement
tree requirement is capped, at least 3 of the replacement trees in section 3(A) must be
selected from the PROTECTED TREE LIST (City Code 3.05.009)
NOTE B – In accordance with City Code The City Arborist may reduce the required number
of replacement trees for a protected tree under section 3(B) from 3 replacement trees to 1
replacement tree if the City Arborist determines the application qualifies as an “Emergency
Tree Work/Retroactive Permit Application” or if the Applicant provides sufficient
documentation from a certified Arborist that the protected tree is diseased, dead, or poses an
imminent or immediate threat to persons or property due to natural causes only. (City Code
3.05.009(d))
(C) GOOD NEIGHBOR REPLANTING
Check here if submitting Good Neighbor Replanting forms for one or more of the Replacement Trees
in Section 3(A) and Section 3(B)
Provide a statement below to how the benefit to residents of the City by replanting on the Neighbor
property would be as great as replacement on the Applicant’s property (or attach a statement)
_________________________________________________________________________
Identify the tree numbers/species from section 3(A) or 3(B) to be planted on a neighbor property,
neighbor name, and attach the signed Good Neighbor Planting Consent form for each property.
TREE #
REPLACEMENT TREE SPECIES
NEIGHBOR NAME
CITY OF ROLLINGWOOD TREE REMOVAL PERMIT APPLICATION
4
(D) TREE PLAN
A. A. Draw your property (and any Good Neighbor replanting properties) with tree plan in the space below or
attach a tree plan drawing
B. B. Tree plan must show:
a. - Existing trees
b. – Location and species of trees proposed for removal
c. – Location and species of trees proposed for replanting
d. - Distance between tree proposed for replanting and any other trees or structures
C. C. Street names, property lines, building(s) outline, driveway, and/or any other pertinent information
relevant to tree replanting and survival feasibility
CITY OF ROLLINGWOOD TREE REMOVAL PERMIT APPLICATION
5
SECTION 5
Acknowledgement Statement
I __________________________, the property owner or authorized representative, complying with
the following statements.
I certify that the facts and information set forth in this application are true and complete to the best of
my knowledge. I understand that any falsification, misrepresentation or omission of fact (whether
intentional or not) in this application or any other required document, as well as any misleading
statement or omission, may be cause for revocation of the permit, regardless of how or when
discovered. I certify that I have done my due diligence to determine that I do need to submit a Tree
Removal Permit Application, and understand that the application fee is non-refundable if in fact a
permit is not required. I have marked the trees requested for removal with ribbon for identification.
I agree to comply with City of Rollingwood Code 3.05, Division 2 and City Code 8.06 regarding tree
removal and replacement. I understand that submitting an application does not entitle me to a
permit and I must have physical possession of the permit before beginning any work. Failure to
obtain a permit or violating the terms of a permit may result in civil penalties up to $2000 per tree per
day in accordance with City Code Title 3.05.014; additional fines may also apply. I agree to hold
harmless the City of Rollingwood, its agents, officers, and employees for any damage or injury
caused by reason of planting, placement, maintenance, or removal of trees.
If a Tree Removal Permit is granted, I agree to meet all tree planting requirements as outlined in the
conditions of the permit. I understand that planting Replacement Tres is a condition of a tree
removal permit. I understand that I am responsible for the successful establishing of the
Replacement Trees.
The property owner or authorized representative hereby give permission to the City of Rollingwood
and its agents, officers, and employees to enter the property for the purpose of tree inspection prior
to permit issuance and for replanting compliance inspection after the permit is issued.
If the trunk of the protected tree(s) straddles the property line, all owners must sign the removal
application. The neighboring property owner must consent to the tree(s) removal by signing below.
By signing below, I hereby acknowledge I understand and will comply with the statements above
and that I am the owner of the property or an authorized representative.
Signature (required) ______________________________ Date: _______________
If applicable, Neighboring Owner signature ___________________________ Date: ____________
Please make checks out to: City of Rollingwood
Submit applications in one of two ways:
(1) In person at Rollingwood City Hall @ 403 Nixon Drive
Or
(2) Mail application and fee to: 403 Nixon Drive, Rollingwood, Texas 78746
Need help? Call City Hall at 512-327-1838 or visit during regular Office
Hours (M-F)
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SECTION 1 (City of Rollingwood)

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Completed 25 February 2021

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