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\\File\com\Parks and Recreation\Bin\David Schott\Application for Permit to Plant.docx Revised 10/2016 Application for Permit to: Plant Trees or Shrubs in the Public Right-of-Way Today’s Date: Name: Home Phone: Alternate Phone: Email address: Mailing Address: Address Where Work Will Be Performed: Who Will Perform The Work? Will Above Individual Perform This Work For A Fee? [ ] YES [ ] NO Name of Plant Being Planted Reason for Selecting This Plant Provide a planting plan in the box below – please label each plant, street, house, etc. Use other side or attach another sheet if needed. Be sure to call 811 at least two working days before you dig. Visit www.digline.com for more information. Applicant’s Signature Return form to: Moscow Parks and Recreation, PO Box 9203, Moscow, ID 83843. Please do not write below this line – office use only. Call (208) 883-7084 if questions. [ ] Granted [ ] Denied Permit number: Permit Expires: Administrator’s Signature Date Comments: