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Heritage Tree Register Listing/ Removal Application Page 1 of 4 Development and Permitting Services 333 S. Meridian Puyallup, WA 98371 [PHONE REDACTED] www.cityofpuyallup.org This permit application is for the request to list or remove a tree on the Heritage Tree Register. A heritage tree is defined as a tree with notable characteristics including, but not limited to age, size, location, aesthetics, or association with an event significant to the city of Puyallup. The tree must be in healthy and good condition in order to be considered a candidate for Heritage Tree designation. Submittal Instructions Create an account on Select “Apply for Planning Permit” Select “Heritage Tree Register Listing/Removal” from drop down list. Fill out all sections of the online form and upload all required documents. Note: Failure to upload all the required documents will delay the processing of your application. Applicant Information Name: Street Address: City: State: Zip Code: Phone: E-mail: Location of Tree ☐ Same as Applicant Information Name: Street Address: City: State: Zip Code: Application Fees Application fee: $50 Additional review fees, if applicable: • SEPA review: $250 • Critical area review: $160 • Traffic impact analysis review: $160 1 2 3 ---PAGE BREAK--- Page 2 of 4 Tree Information ☐ Request for listing tree on Heritage Tree Registry ☐ Request for removal of tree(s) from Heritage Tree Registry Do you own the tree proposed to be designated or removed from the Heritage Tree List? ☐ Yes ☐ No Tree Species: Trunk Diameter (at 4.5’ above grade): Tree Height (est.): Tree Canopy Spread (est.): * No heritage tree proposal will be processed without property owner consent UNLESS the tree proposed for designation is on City of Puyallup property (e.g. city park or city right of way). Anyone may request a city-owned tree to be designated through this form. Heritage Tree Listing Criteria Is the tree a significantly large, old, or rare specimen tree? Does the tree have special significance in the overall ‘landscape’ of the city (such as a highly visible tree at a community park or gateway)? Does the tree have an association with historical or community related events? Please describe below and provide any supporting documentation (e.g. newspaper articles, photos, etc.): ---PAGE BREAK--- Page 3 of 4 Heritage Tree Listing Criteria (continued) Do you believe the tree(s) is in overall good condition and healthy? Please describe below and provide any supporting documentation that exists regarding the health of the tree(s) (e.g. arborist report): Describe anything else we should know about this tree(s). Heritage Tree Removal Criteria What are the reasons for the removal request? Please include any information that is reasonably relevant to the removal of the tree from the Heritage tree list: Submittal Checklist ☐ 1. Completed and signed application form ☐ 2. Site Plan (map) of the property with the location of the Heritage Tree to be added/removed identified ☐ 3. Photographs of the tree, preferably from different angles with as much of the tree shown as possible in each photograph. ☐ 4. A description of the tree and its characteristics (for request to add tree to list only). ---PAGE BREAK--- Page 4 of 4 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. It is understood that the processing of this application may require additional supporting evidence, data or statements. Signature of Applicant: Date: Signature of Owner*: Date: (*If different than the Applicant. Owner signature required if the tree(s) are located on private property) SIGN SIGN