A/P#:
PLAT#:
City of San Antonio
Development Services Department
1901 S. Alamo
San Antonio, TX 78204
TREE AFFIDAVIT APPLICATION
(No Protected Trees to be Harmed or Removed)
MAJOR/MINOR:
Inspector’s initials:
Reviewer’s initials:
Date:
Date:
(Office Use Only)
Pass Fail Comments:
Approved Denied Comments:
Applicant Name:
Applicant Information
Company Name:
Phone #:
Address:
Fax#:
City:
Email:
State:
Zip:
Name:
Address:
Owner’s information (if different than
applicant)
Phone:
City:
Fax:
State:
Zip:
Project Name:
Project Information
Unit:
Plat:
Project Address/Location:
Project Type: Residential #
lots Non-Residential #
Outside City Limits:
acres Public Funds:
Yes No
Yes No
Class of Work: Site Work Platting New Structure Geotech
Addition(>2500 ft²)
Parcel Key: (https://gis.sanantonio.gov/PDS/onestop/index.html) (Parcel Key must be included)
Type of Application and Review
Please note: Applicant shall provide habitat compliance form as defined in section 35-B133 of the UDC
for properties with 2.0 or more acres.
Please mark the appropriate box for review (ONLY MARK ONE BOX):
1. Site has no protected Trees, Significant Trees, Heritage, or Historic Trees as defined in the
UDC (Aerial photo required); or
2. Site has Protected Trees, but this work will in no way cause damage to or the destruction of
said trees; I understand such is a direct violation of the provisions of the UDC (Aerial
photo or Tree Survey required and site plan showing limits of construction/building
footprint, if available).
Affidavit
I, (agent/owner), certify that I am aware of Article V, § 35-523 of the
U.D.C. and all related appendices regarding Tree Preservation and agree to adhere to the requirements including any additional
fees determined to be owed to complete this permit.
State of Texas )
)
County of Bexar ) Signature
Before me, the undersigned authority on this day personally appeared
known to me to be the
person whose name is signed to the foregoing affidavit and sworn by me, state under oath that all of the facts therein set forth are
true and correct.
Sworn to before me, this
_day of
, 20
. Notary Public in and for the State of Texas
Forms and additional information can be found at:
http://sanantonio.gov/DSD/Constructing/Tree.aspx Development Services Department / March 2018