Shade Tree Permit Application

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Date *

TO THE SECRETARY OF SPRINGFIELD TOWNSHIP: SHADE TREE COMMISSION

The undersigned makes application for a permit under the provisions of Ordinance Number 1341 of Springfield Township entitled "Shade Tree Commission of Springfield Township" approved June 9, 1998, and under any supplements or amendments thereto:

Applicant First Name *

Applicant Last Name *

Phone *

Applicant *

City *

State *

Zip *

Is Applicant Owner of the Property? *

Yes No

Nature of Work *

Location of Trees *

Species of Trees *

Shade Tree Permit Application

Owner First Name *

Owner Last Name *

Owner Phone *

Address *

State *

City *

Zip *

Does the Owner approve of the work specified? *

Yes No

Shade Tree Permit Application

REMARKS:

The applicant agrees to comply with all provisions of the above-mentioned ordinance of the Township or any supplement or amendment thereto.
The applicant agrees to replace any street tree removed per §123-39A(4) of Chapter 123 or § 143-116(2) or Chapter 143. The tree shall be a species approved by the Township and for a minimum caliper of 3½ inches at the time of planting. Attached is a list of approved plantings.

Contractor

First Name *

Last Name *

Phone *

Address *

City *

State *

Zip *

Applicant Signature

Shade Tree Permit Application

TO THE SECRETARY OF SPRINGFIELD TOWNSHIP: SHADE TREE COMMISSION

Shade Tree Permit Application

Shade Tree Permit Application

Contractor

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