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Parks Department Contact Information Jen Sybrant, Urban Forester (406) 260-5133 and Philip Hodge, Arborist (406) 885-0049 Jennie Bradford, Operations Specialist (406) 863 1253 PUBLIC TREE IMPACT FORM When excavation / construction is planned to take place within 50 feet of a public tree, this form must be completed and submitted with your application. This form will be reviewed and completed by the Parks and Recreation Department. Permits/Approvals will not be issued until the required conditions are met and applicable payment has been remitted. I) General Information: Name of Applicant: Contact Phone: Email: Permit being applied for excavation, building, land use): Project Name (if applicable): Project Address: Number of Impacted Public Trees: Public Tree Locations: Public Tree Species (if known): Diameter at Breast Height (DBH): Number of public trees on adjacent properties with canopies extending into project area: II) Proposed Impact to Tree(s): Check all that apply Excavation within 50’ of a public tree Construction within 50’ of a public tree Requested removal of a public tree Applicant Signature: Date: Parks & Recreation / [EMAIL REDACTED] / P.O. Box 158, Whitefish, MT 59937