DATE: ______________________________________ FEE: _______________________
APPLICANT INFORMATION
NAME: ______________________________________________ PHONE: __________________________
ADDRESS: _____________________________________________________________________________
SITE INFORMATION
ADDRESS OF TREE(S) REMOVED: _________________________________________________________
OWNER: _______________________________________________________________________________
GEO PIN NUMBER: _______________________________________________________________________
TREES REMOVED
Number
Size (inches in
diameter)
Type/Species
Reason for Removal
NOTE: ALL TREE REMOVAL SHALL BE CONDUCTED IN COMPLIANCE WITH ARTICLE 11 OF THE
TOWN OF BURGAW UNIFIED DEVELOPMENT ORDINANCE.
Applicant Signature: ______________________________________________ Date: __________________
FOR OFFICE USE ONLY
Permitted by: ____________________________________________________ Date: __________________
Denied by: ______________________________________________________ Date: __________________
Reason for Denial, if applicable: ___________________________________________________________
TREE REMOVAL PERMIT
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