TREE AFFIDAVIT / PERMIT APPLICATION

mobdescriptiveSoftware and s/w Development

Oct 28, 2013 (3 years and 9 months ago)

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A/P

City of San Antonio

Planning and Development Services Department

1901 S. Alamo

San Antonio, TX 78204

TREE AFFIDAVIT / PERMIT APPLICATION










Project Address/Location:







Outside City Limits?


Y

N


Project Name/Subdivision:







Unit:







Plat
#:








Parcel Key

(http://maps.sanantonio.gov/imf/sites/DevServices/jsp/launch.jsp):







Lot No.







Block:







NCB/CB:








Class of Work (Check as Appropriate):


Site Work

Platting

New Structure

Addition (


2500 ft
2
)


Project Type

(C
heck as Appropriate):


Commercial # acres








Residential # lots









Company ID#:







Contact ID#:







Public Funds Used:


Y

N


Contact Person:







Company Name:








Email:







Phone #







Fax #








Owner:







Phone #







Fax #








Address:







City







Stat
e




Zip










A
PPLICANT SHALL PROVI
DE HABITAT COMPLIANC
E FORM AS DEFINED IN

35
-
B133

(
FOR PROPERTIES
2.0

ACRES AND LARGER
).

I
F A MASTER TREE PERM
IT OR TREE PL
AN WAS PREVIOUSLY AP
PROVED
,

PROVIDE AP
#







P
LEASE MARK THE APPRO
PRIATE BOX FOR REVIE
W
(
ONLY MARK
ONE

BOX
):


1.

has no Protected, Significant, Heritage, or Historic trees as defined in Article V, § 35
-
523 or 35
-
6111 of the U.D.C. (
AE
RI AL
PHOTO REQUI RED FOR 2003/2006 ORDI NANCE)
;
OR


2.

has protected trees, but this work will in no way cause damage to or the destruction of said trees; I understand such is a di
rect
violation of the provisions of Article V, § 35
-
477B(b)(
2) or 35
-
6106 (
AERI AL PHOTO OR TREE SURVEY REQUI RED FOR 2003/2006

ORDI NANCE
);
OR


3.

is exempt from the Tree Preservation Ordinance


Rights Determination # is required: (Aka Vested Rights Permit)

(
REQUI RES A $250 REVI EW FEE AND SI TE PLAN

OF PROJECT AREA);






OR


4.

has Protected, Significant, Heritage or Historic trees that will be removed. (
REQUI RES ADDI TI ONAL SI TE PLAN & TREE


I NVENTORY SUBMI TTED
)


I,







(
agent/owner
), certify that I am aware of Article V, § 35
-
523 of the U.D.C. and all

related appendices regarding Tree Preservation and agree to adhere to the requirements including any additional fees determin
ed to be owed to
com
plete this permit.


State of Texas

)



)













County of Bexar

)







Signature


Before me, the undersigned authority on this day personally appeared







known to me to be the
person whose name is signed to the foregoing affidavit and sworn by m
e, states under oath that all of the facts therein set forth are true and correct.


Sworn To Before me, this



day of




, 20

.











___________________________________








Notary Public In And For The State of Texas


http://www.sanantonio.gov/ds
d/environmental.asp




Planning and Development Services Department / Revised June 2009

(Office Use Only)

INSPECTOR INITIALS


DATE


PASS / FAIL

_____ APPROVED

_____ NOT APPROVED INITIALS



DATE