TOWN OF BEAUX ARTS VILLAGE
Form Name: Tree Removal Permit Application
Last Update: 10/2019
BUILDING DEPARTMENT
PERMIT NO. TR
The correct number of permit
application documents pertinent
to this project have been included
in this submittal
x ________________________
(Applicant Initials)
ACCEPTED _____________
APPROVED _____________
ISSUED ________________
DATE ________
DATE ________
DATE ________
10550 SE 27th Street
Beaux Arts, WA 98004
425.269.6985 Fax 425.688.1786
email: bldgdept@beauxarts-wa.gov
FOR INSPECTIONS CALL:
Tree Solutions, 206-528-4670
REMOVAL OF TREES
IN RIGHT-OF-WAY
PROHIBITED
BLDG PERMIT NO. _______
DATE ________
APPLICATION FOR TREE-REMOVAL PERMIT
ZONING __________________________
PHONE ___________________________
ZIP CODE _________________________
PHONE ___________________________
ZIP CODE _________________________
PHONE ___________________________
ZIP CODE _________________________
ZIP CODE _________________________
ZIP CODE _________________________
TAX NO.___________________________
PROPERTY LEGAL DESCRIPTION ______________________________________________________________________________
___________________________________________________________________________________________________________
_______________________________________________
ASSESSOR’S PARCEL NO. ___________________ - ______________
(Attach separate legal description, if necessary)
TREE REMOVAL TYPE
TREE SIZE
TREE TYPE AND UNITS
HAZARDOUS TREE
LANDMARK
CONIFEROUS
"20% RULE" REMOVAL
SIGNIFICANT
EVERGREEN
Specify
MATURE
MADRONE
____________________________________
OAK
BIG LEAF MAPLE
OTHER: Specify
____________________________________
IS WORK WITHIN 200 FEET OF LAKE WASHINGTON ORDINARY HIGH WATER LINE? YES NO
I certify under penalty of perjury that I am the owner of the above described property or the duly authorized agent of the
owner(s) acting on behalf of the owner(s) and that all information furnished in support of this permit application is true and
correct. I further certify that all applicable Federal, state, county, and Town of Beaux Arts Village requirements for the work
authorized by this permit will be met.
SIGNATURE _______________________________________________________ OWNER AGENT DATE _______________
This section to be completed by Town staff:
MITIGATION REQ'D? (describe briefly or attach separate sheets) _____________________________________________________
__________________________________________________________________________________________________________
__________________________________________________________________________________________________________
ARBORIST REVIEW FEE $ _______________
PERMIT FEE $ _______________
RECEIPT NO. _________
TOTAL DUE AT ISSUE _______________
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