Date _____________________ Permit Application #_________________________________________ I hereby certify that this application is correct. It is understood that any deviation from the permit conditions will render the permit null and void and shall be considered as a violation of Pinellas County land Development Code 166.81. This application is for the purpose of developing the below-described property and/or for the purpose of removing: tree(s) for the following reason :
Street Address City Zip
Subdivision Name_______________________________________________________________________
For Officer Use Only Conditions: Within ______ days, an inspection will be made to verify ______ trees remain, and ______ trees have been planted, 6' in height, 1.5" caliper, selection to be made from the tree replacement species list, being Nursery Grade #1. Undersize trees remaining on site will count toward this requirement if they are of a species on the replacement list, and at least 6' in height and in good condition. THIS IS YOUR PERMIT AND RECEIPT Pd. $_____________ Coll. $______________ CPR # ______________ _________________________________ (Env. Officer's signature) (date issued)
Directions to site:______________________
