CONTRACTOR OR APPLICANT INFORMATION
COMPANY NAME:
PHONE NO.:(______)_________________ FAX.:(______)___________________
NAME: ____________________________________________________________________________
Last First
ADDRESS:_______________________________________________________________________
Street City State Zip
PROPERTY INFORMATION
JOB STREET ADDRESS:______________________________________________________________
JOB AD VALOREM TAX PARCEL NUMBER:____________________________________________
(REQUIRED FOR ISSUANCE)
IF METES AND BOUNDS ATTACH PHOTOCOPY OR DEED OR SURVEY WITH LEGAL DESCRIPTION
PROPERTY OWNER NAME:____________________________________________________________
Last First
ADDRESS:__________________________________________________________________________
Street City State Zip
PHONE NO.: (______)_________________________ FAX.:(______)___________________________
PERMIT INFORMATION
Permit for: Trimming ____ Removal ___ Pruning ___ Other _____
Reason for permit request: ____________________________________
Use separate sheet if needed.
__________________________________________________________
__________________________________________________________
Number of Trees:___________ Number of Acres:__________________
____ Live Oak
____ Willow Oak
____ Swamp Chestnut Oak
____ Overcup Oak
____ Shumard Oak
____ Nuttall Oak
____ Southern Magnolia
____ Sweet Bay
____ Sweetgum
____ Red Maple
____ American Holly
____ Bald Cypress
____ Other trees registered
with Societes des Arbes
__________________________________________________________________________________________________________________________________________________________________________________________________________________________
ADDITIONAL INFORMATION
REQUIRED FROM APPLICANT
Site plan in quadruplicate (4) showing
the following information at a scale
sufficient to enable the determination
of matters required under the Tree
Protection Ordinance:
(1) The shape and dimensions of
the lot or parcel, together with the
existing and proposed locations of
structures and improvements, if any.
(2) Location and dimensions of all
protected trees identified by common
or botanical name. Trees proposed
to remain, to be relocated or to be
removed shall be so identified.
Groups of trees in close proximity,
three (3) foot spacing or closer, may
be designated as a “clump” of trees,
and predominant species, estimated
number, and average size listed.
(3) A statement showing how trees not
proposed for removal are to be
protected during land clearing and
construction, i.e., a statement as to
proposed Protective Barriers as
defined in Section 8-12.
(4) Statement as to grade changes
proposed for the lot or parcel and
how such changes will affect these
regulations.
(5) Any proposed tree replacement;
program.
(6) The Tree Protection Advisor may
require the applicant to furnish
additional information as necessary
and appropriate to properly analyze
the application.
CITY OF GULFPORT
TREE PERMIT APPLICATION VER. 9/19
PLEASE PRINT LEGIBLY
DATE RECEIVED: _________________ TREE PERMIT #___________________
1410 24
th
Avenue, Gulfport, Mississippi 39501 (228) 868-5715
Please read and fill in ALL information that is requested. Failure to complete this application
may result in a delay in issuing the desired permit.
*** CALL BEFORE YOU DIG! 1-800-227-6477 ***
It shall be the responsibility of the owner of the property and the contractor on this
application for the removal of all limbs, stumps and other related material after said
trimming or tree removal.
Tree Permit Fee Schedule
RESIDENTIAL AND
COMMERCIAL (IMPROVED)*
One Tree: $25.00
Each additional tree $10.00
Plus the Minimum Charge of $30.00 per
half acre, but the Maximum Charge is
$250.00 per half acre of property.
RESIDENTIAL AND
COMMERCIAL (UNIMPROVED)*
One Tree: $35.00
Each Additional Tree: $15.00
Plus the Minimum Charge of $30.00 per
half acre, but the Maximum Charge is
$250.00 per half acre of property.
*Subject to a $30.00 permit fee.
OFFICIAL USE ONLY
Approved ____ Denied_____ (See Comments on back.)
Signature________________________ Date: __________________________
Application is hereby made to the City of Gulfport, Mississippi for official permission
for tree removal alteration, and/or planting within the City limits of Gulfport,
Mississippi. I, the undersigned applicant/ contractor, affirm that the above information
is true and correct, and that I have full authority over the description of work to be
performed. Furthermore, I understand the tree advisor has fourteen (14) working days
to issue or deny the application.
FEE: __________ SIGNATURE: _________________ DATE:____________
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