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Office Use Only PROJ: DATE: TREE: ACCEPTED BY: PAYMENT METHOD: TYPE: By my signature, under penalty of perjury, I certify that I am the property owner or authorized to file this application on the property owner’s behalf. Print Name: Date: Signature: Name of Property Owner(s): Site Address: Tax Parcel Number: Property Square Footage: Location of trees to be removed: ☐ Front ☐ Side ☐ Rear Select Billing Contact: APPLICANT OWNER BUILDING OWNER OR AUTHORIZED AGENT Applicant Company Name: Mailing 1. Complete Application Form 2. Site Sketch [ see * on bottom of next page for new single-family construction] 3. Arborist tree assessment for each hazardous tree [use Redmond Tree Health Assessment Form]. Site photos may be submitted in lieu of Assessment Form if photos show evidence of dead, diseased, or dying tree(s). Photos can be attached to this application. 4. Completed Exception Request Form for healthy Landmark tree removal or exceeding maximum # of trees allowed for removal. 5. No fee for single-family zoning; $125.69 fee for commercial, multi-family, or industrial. SUBMITTAL REQUIREMENTS Tree Species Tree Diameter (4.5 feet above grade) Dead, diseased, or dying Total Hazard Rating Protected Tree or within a Critical Area Proposed Replacement Ex. Douglas Fir 18” Dead 9 No Cedar 1. 2. 3. 4. 5. 6. TREE INFORMATION Tree Removal Application PROPERTY INFORMATION Development Services Center, 15670 NE 85th St, Redmond, WA 98052 I [PHONE REDACTED] APPLICANT INFORMATION SIGN ---PAGE BREAK--- I, have evaluated the trees listed as dead, diseased, dying, or has a significant structural defect in the table under “Tree Information” and determined that the trees are structurally unsound and pose a hazard to property. My analysis supporting this finding can be found in the attached Tree Hazard Assessment Form(s). Certified Arborist Signature Arborist Certification # and Expiration Date Phone Number Email Address CERTIFIED ARBORIST DOCUMENTATION Development Services Center, 15670 NE 85th St, Redmond, WA 98052 I [PHONE REDACTED] SITE SKETCH *New Single –Family Construction: For tree removal associated with the construction of a new single-family home or an addition to an existing single family home, please include a scaled site plan on a separate sheet in lieu of a Site Sketch (above). Please use the site plan you submitted with your building permit and show the location of trees to be removed as part of the construction. SIGN ---PAGE BREAK--- Per the RZC 21.72.090, a written request for an exception is required for the removal of healthy landmark trees or to remove more trees than the maximum allowed per year (365 days). I, am requesting the removal of healthy landmark tree(s) and/or trees (name of property owner) of trees) of trees) above the maximum allowed per year as described on the application form attached to this Exception form. The tree(s) is/are located on my property at I feel that an exception consistent (property address) with the criteria under RZC 21.72.090 is necessary for the reasons described below: 1. *Special Circumstances related to the size, shape, location or surrounding of the property. (Give examples for each tree such as the tree is lifting/damaging the house foundation) 2. *Reasonable Use of Property is jeopardized by the strict compliance with the provisions of the code. (Give example for each tree such as the tree interferes with the house foundation or location of utilities). 3. Proposed vegetation removal, replacement, and any mitigation measures are consistent with the purpose and intent of the code. (Give examples for each trees such as tree replacement proposed to mitigate for tree(s) removed). 4. The proposed request will not be detrimental to the public welfare or injurious to other property. (explain why) Signature of Property Owner Date * Answer question 1 or 2, as applicable TREE REMOVAL EXCEPTION REQUEST FORM Development Services Center, 15670 NE 85th St, Redmond, WA 98052 I [PHONE REDACTED] SIGN ---PAGE BREAK--- Tree Health Evaluation Form must be completed by a certified arborist. One evaluation form per tree. I. TREE CHARACTERISTICS III. SITE CONDITIONS FOLIAGE COLOR: ☐ Normal ☐ Chlorotic ☐ Necrotic FOLIAGE DENSITY: ☐ Normal ☐ Sparse EPICORMICS? ☐ Y ☐ N LEAF SIZE: ☐ Normal ☐ Small TWIG DIEBACK? ☐ Y ☐ N ANNUAL SHOOT GROWTH: ☐ Excellent ☐ Average ☐ Poor WOUNDWOOD DEVELOPMENT: ☐ Excellent ☐ Average ☐ Poor ☐ None VIGOR CLASS: ☐ Excellent ☐ Average ☐ Fair ☐ Poor GROWTH OBSTRUCTIONS: ☐ Stakes ☐ Wires/ties ☐ Signs ☐ Cables ☐ Guard ☐ Curb/Pavement ☐ Other: MAJOR PESTS/DISEASES: II. TREE HEALTH Development Services Center, 15670 NE 85th St, Redmond, WA 98052 I [PHONE REDACTED] Tree Health Assessment TREE SPECIES: DBH: # OF TRUNKS: HEIGHT: SPREAD: FORM: ☐ Generally Symmetric ☐ Minor Asymmetry ☐ Major Asymmetry ☐ Stump Sprout ☐ Stag-headed CROWN CLASS: ☐ Dominant ☐ Co-Dominant ☐ Intermediate ☐ Suppressed LIVE CROWN RATIO: AGE CLASS: ☐Young ☐ Semi-Mature ☐ Mature ☐ Over-Mature/Senescent PRUNING HISTORY: ☐ Crown cleaned ☐ Excessively Thinned ☐ Topped ☐ Crown Raised ☐ Crown Reduced ☐ Flush Cuts ☐ Pollarded ☐ None ☐ Cabled/braced ☐ Multiple Pruning Events Approximate SPECIAL VALUE ☐ Specimen ☐ Heritage/Historic ☐ Wildlife ☐ Unusual ☐ Street Tree ☐ Screen ☐ Shade ☐ Indigenous ☐ Protected by Government Agency SITE CHARACTER: ☐ Residence ☐ Commercial ☐ Industrial ☐ Park ☐ Natural ☐ Woodland/Forest ☐ Open Space LANDSCAPE TYPE: ☐ Parkway ☐ Raised Bed ☐ Container ☐ Mound ☐ Lawn ☐ Shrub Border ☐ Windbreak IRRIGATION: ☐ None ☐ Inadequate ☐ Adequate ☐ Trunk wetted ☐ Excessive RECENT SITE DISTURBANCE? Y N ☐ Construction ☐ Soil Disturbance ☐ Grade Change ☐ Line clearing ☐ Site Clearing % DRIPLINE PAVED: ☐ 0% ☐ 10-25% ☐ 26-50% ☐ 51-75% ☐ 76-100% PAVEMENT LIFTED? ☐ Y ☐ N % DRIPLINE WITH FILL SOIL: ☐ 0% ☐ 10-25% ☐ 26-50% ☐ 51-75% ☐ 76-100% % DRIPLINE GRADE LOWERED: ☐ 0% ☐ 10-25% ☐ 26-50% ☐ 51-75% ☐ 76-100% SITE/ADDRESS: MAP/LOCATION: DATE: ARBORIST ARBORIST CERTIFICATION DATE OF LAST INSPECTION:___________ Tree Health Assessment Form must be completed by a certified arborist. One evaluation form per tree. ---PAGE BREAK--- ROOTS: SUSPECTED ROOT ROT: ☐ Y ☐ N MUSHROOM/CONK/BRACKET PRESENT: ☐ Y ☐ N ID: EXPOSED ROOTS: ☐ Severe ☐ Moderate ☐Low UNDERMINED: ☐ Severe ☐ Moderate ☐ Low ROOT PRUNED: Distance from trunk ROOT AREA AFFECTED: BUTTRESS WOUNDED: Y N WHEN: RESTRICTED ROOT AREA: ☐ Severe ☐ Moderate ☐ Low CROWN: Indicate presence of individual defect’s location (root crown, trunk, scaffolds, branches) & rate their severity (S=severe, H=high, M= moderate, L= low) Defect Defect Area Defect Severity Defect Defect Area Defect Severity Poor Taper Decay Bow, Sweep Cavity Co-Dominants, Forks Conks/Mushroom/Bracket Multiple Attachments Bleeding/Sap Flow Included Bark Loose/Cracked Bark Excessive End Weight Nesting Hole/Bee Hive Cracks/Splits Deadwood/Stubs Hangers Borers/termite/ants Girdling Cankers/Galls/Burl Wounds/Seam Previous Failure LEAN: Degrees from vertical ☐ Natural ☐ Unnatural ☐ Self-corrected DECAY IN PLANE OF LEAN: ☐ Y ☐ N ROOTS BROKEN: ☐ Y ☐ N SOIL CRACKING: ☐ Y ☐ N SOIL HEAVING: ☐ Y ☐ N COMPOUNDING FACTORS: LEAN SEVERITY: ☐ Severe ☐ Moderate ☐ Low OTHER RISK FACTORS ☐ 0 POINTS ☐ 1 POINT ☐ 2 POINTS This category can be used if professional judgment suggests the need to increase the risk rating. It can also be used if the tree is likely to fail before the next scheduled risk inspection. SIZE OF DEFECTIVE PART ☐ 1 POINT ☐ 2 POINTS ☐ 3 POINTS DESCRIPTION & COMMENTS: 1 Point Parts less than 4 inches in diameter 2 Points Parts from 4 to 20 inches in diameter 3 Points Parts greater than 20 inches in diameter V. RISK RATING IV. TREE STRUCTURE III. SITE CONDITIONS, CONTINUED Development Services Center, 15670 NE 85th St, Redmond, WA 98052 I [PHONE REDACTED] SOIL PROBLEMS: ☐ Drainage ☐ Shallow ☐ Compacted ☐ Droughty ☐ Saline ☐ Alkaline ☐ Acidic ☐ Small Volume ☐ Disease Center ☐ History of Fail ☐ Clay ☐ Expansive ☐ Slope ☐ OBSTRUCTIONS: ☐ Lights ☐ Signage ☐ Underground Utilities ☐ Line-of-Sight ☐ View ☐ Traffic ☐ Overland Lines ☐ Adjacent Vegetation ☐ EXPOSURE TO WIND: ☐ Single Tree ☐ Below Canopy ☐ Above Canopy ☐ Recently Exposed ☐ Windward, Canopy Edge ☐ Area prone to PREVAILING WIND DIRECTION: OCCURRENCE OF SNOW/ICE STORMS: ☐ Never ☐ Seldom ☐ Regularly ---PAGE BREAK--- DESCRIPTION & TREE PART MOST LIKELY TO FAIL: INSPECTION PERIOD: annual PROBABILITY OF FAILURE ☐ 1 POINT ☐ 2 POINTS ☐ 3 POINTS ☐ 4 POINTS Point Risk Description Part Description 1 Low Some minor defects Minor branch/crown dieback Minor defects or wounds 2 Moderate Several moderate defects present Indicators of advanced decay are found on 25-40% of circumference of any stem, branch, or root collar. Shell thickness is >1 and <2 inches of sound wood for each 6 inches of stem diameter and stem has opening < 30% of stem circumference. Stem has a single crack and decay Roots within the area defined by the Critical Root Radius are less than or equal to 40% damaged, decayed, severed, or dead. Branch union has included bark. Canker or canker plus decay affect 25-40% of tree’s circumference Branch has a sharp bend or twist. Large horizontal branch with several vertical branches on it. 3 High Multiple or significant defects present Indicators of advanced decay are found on more than 40% of the circumference of any stem, branch or root collar. Stem has advanced decay and the shell thickness is either less than 1 inch of sound wood for each 6 inches of stem diameter, or stem has opening greater than 30% of the stem circumference and shell thickness is less than 2 inches of sound wood for each 6 inches of stem diameter. Stem is split in two by a crack or branch has a crack. Stem segment has multiple cracks and decay. Leaning tree with recent evidence of root lifting, soil movement or soil mounding. Roots within the area defined by the Critical Root Radius are more than 40% damaged, decayed, severed, or dead. Weak union is also cracked, cankered, or decayed. Large epicormic branch on decaying stem. Canker or canker plus decay affect more than 40% of tree’s circumference. Tree with excessive lean (more than 40%). Leaning tree has a crack in stem or canker or decay on lower stem. Leaning tree has a horizontal crack on the upper side of the lean and/or buckling bacrk and wood on lower side. Any lodged branch. Any dead tree, tree top, or branch. 4 Severe Multiple AND significant defects present listed under “High” risk; visual obstruction of traffic signs/ lights or intersections DESCRIPTION & COMMENTS: TOTAL RISK RATING (SIZE OF PART + OTHER RISK FACTORS + FAILURE POTENTIAL): RISK RATING : ☐ Low (0-1 points) ☐ Moderate (2-3 Points) ☐ High (4-6 points) ☐ Severe (7-9 points) PRUNE: ☐ Remove Defective part ☐ Reduce end weight ☐ Crown clean ☐ Thin ☐ Raise canopy ☐ Crown reduce ☐ Restructure ☐ Shape CABLE/BRACE: INSPECT FURTHER: ☐ Root crown ☐ Decay ☐ Aerial ☐ Monitor REMOVE TREE? ☐ Y ☐ N REPLACE? ☐ Y ☐ N OTHER: ON ADJACENT DATE: V. RISK RATING, CONTINUED VI. RISK ABATEMENT Development Services Center, 15670 NE 85th St, Redmond, WA 98052 I [PHONE REDACTED]