City of Castroville
Community Development Department
703 Paris Street
Castroville, TX 78009
TREE AFFIDAVIT APPLICATION
(No Protected Trees to be Harmed or Removed)
(Office Use Only)
Pass
Inspector’s initials:_______ Date:_________
Reviewer’s initials:_______ Date:_________
Approved
Fail Comments:____________________________________________
Denied Comments:____________________________________________
Applicant Information
Applicant Name: _______________________________ Company Name:________________________
Phone #:____________________ Fax#:__________________ Email:____________________________
Address:__________________________________ City:__________________ State:____ Zip:________
Owner’s information (if different than applicant)
Name:_____________________________________ Phone:_______________ Fax:________________
Address:__________________________________ City:__________________ State:____ Zip:________
Project Information
Project Name:_________________________________________________ Unit:______ Plat:_________
Project Address/Location:_____________________________________ Outside City Limits:__Yes __No
Project Type: Residential #______lots Non-Residential #______acres Public Funds:__Yes __No
Class of Work: Site Work Platting New Structure Addition(>2500 ft²)
Parcel Number: (www.medinacad.org) __________________________________________
Please mark the appropriate box for review (ONLY MARK ONE BOX):
1.
Site has no Protected Trees (Significant Trees, Heritage Trees, Floodplain Trees, or Legacy
Trees) as defined in the City Code, Chapter 99 (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 City Code, Chapter 99
(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 Chapter 99 of the City of
Castroville's Code of Ordinances and all related regulations 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 Medina )
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
