6850 SW 67 ST_GREEN TREE :� Y f +�►
4
t 4 i
E City. of South Miami' .
e° 3VSun,Pt Drive, South Miami, Florida 33143
APPLICATION FOR TREE REMOVAL PERMIT- ���
Owner and Contractor Information
OWNER { i CONTRACTOR/AGENT
Name Name
Address l e0o 102V Zip 33�ZS Address Zip
Phones` C3o5� 3� / Phone
Site Location and Description Address l�8 so S W '7 sf
Building Permit Process # Property Folio N
Lot Block Subdivision
Sec Twp. Rg Lot size S
Current Zoning Proposed use of property SlN�" T t� tl E'S I
Does the intended use of the property required rezoning or plat approval ? ' Yes No
Work Description
Number and type of trees to be removed:
Reason for relocation or removal: a N STP--u GTR s -J
Do not write below this line (offlcal use only) "
TREE REMOVAL PERMIT NO.
Inspector Area Validation Date
Cert. of Occupancy Withheld O Environmentally Sensitive O
Approval Conditions
c'oyA�
S H A-D - 77?-E S /Z' Q-1W
X 11 A4, E> 0r J ; .�.. 740
O Landscape plan due.
®' Barrier Inspection/date
FAILURE TO COMPLY WITH THE CONDITIONS OF THIS TREE REMOVAL PERMIT MAY RESULT IN THE ISSUANCE OF CIVIL VIOLATION
NOTICES FOR EACH OFFENSE PURSUANT TO CHAPTER 8CC OF THE DADE COUNTY CODE.
Inspection Type/Fee Inspection Type/ Fes App. Fee S
Need for Compliance S Preservation Area Location$ Total Inspection Fees>i
Barrier S _ Landscape Plan Review S No. of trees/lots/acres
Utility, Road Siting S— Landscape Field Insp. $ Cost per treesAodacre S
Miscellaneous ( ) $ Total$
I UNDERSTAND THAT IN SIGNING THIS PERMIT,.I AM RESPONSIBLE FOR THE SUPERVISION IN ACCORDANCE WITH THE PLANS AND
ABOVE CONDITIONS AND FOR COMPLIANCE WITH ALL FEDERAL, STATE, AND COUNTY LAWS APPLICABLE.
SIt�iPlATURE OF APPLICANT DATE SIGNED