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1 Application Information Applicant Information: Name Street Address City State Zip Phone Fax E-mail Location of Tree Work: (if different than the applicant’s info) Name Street Address City State Zip Phone Fax E-mail This permit application is only required if you would like remove a significant tree or any tree in critical areas. Significant trees are all healthy and growing trees greater than fifteen (15) inches DBH (diameter breast height = 4.5’ above ground). Critical areas are a wetland or wetland buffer, steep slope/erosion hazard area, habitat area or stream buffer, and all buffer areas that are associated with these natural sensitive features. When preparing this application, please print or type the reply to each question. If you have any questions, please contact the Development Services Center at (253) 864-4165. Application Fee: Free Office Use Only: Submittal Date: Case No: GIS: Inventory: CITY OF PUYALLUP Planning Division 333 South Meridian Puyallup, WA 98371 Phone: [PHONE REDACTED] Fax: [PHONE REDACTED] Email: [EMAIL REDACTED] Checklist: All significant trees and trees in critical areas or buffers shall be examined by a certified arborist - with a certification in Tree Risk Assessment (TRAQ) - prior to application for removal. Please include the Tree Risk Assessment report when submitting your permit request. In critical areas, the landowner shall replace any trees that are felled with new trees at a ratio of two replacement native trees for each one tree removed, within one year in accordance with an approved restoration plan. See page 2. Application to Remove a Tree Tree Work Information: Do you own the home at the location of tree work? yes no Which tree service do you plan on hiring to do the requested work? Company Name Contact Name (Certified Arborist) Arborist Cert. # Phone Fax E-mail Have you contracted with this company yet? yes no Expected starting date of tree work: Expected ending date of tree work: ---PAGE BREAK--- 2 Tree Removal: Is the proposed tree(s) to be removed in a critical area (i.e. is the tree located in a wetland or wetland buffer, steep slope/erosion hazard area, habitat area or stream buffer)? yes no I do not know Indicate the type and quantity of trees that need to be removed. Tree Type/Species DBH Height Quantity Tree Replacement: Will you be replacing a tree to be removed? If so, please describe the species, quantity, location, spacing and when the replant will take place for each tree type. Please note – all trees removed from a critical area are required to be replaced with two new trees for each one removed. Tree Type/Species/nursery size Quantity Location Spacing Date Describe the work requested and anything else we should know about this tree(s). Please be as specific as possible. Please be sure to provide the justification for this tree removal proposal. If needed, you may use illustrations in the space below or attached to this permit. CERTIFICATION: I hereby state that I am the applicant listed above, and certify that all information contained above and in exhibits attached hereto is true and correct to the best of my knowledge and belief and is submitted for consideration by the City of Puyallup, pursuant to the provision of the Puyallup Municipal Code. Signature of Applicant Date Signature of Owner Date (If different than the Applicant)