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HomeMy WebLinkAboutPROTECTED TREE REPORT CITY OF ARCADIA IRE 1 6 �3 Z
PROTECTED TREE PERMIT
ENCROACHMENT INTO A PROTECTED ZONE
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ANC Aron
PLEASE COMPLETE THE FOLLOWING INFORMATION (REQUIRED) :
PROJECT ADDRESS 7 S---- a-,14 7 RM 7 Pik d ` --
APPLICANT(S) NAME 32 it 0 //J7evI/L.t*Io'v1 ,/�L
MAILING ADDRESS 2 - _ f7 / IJaA-GI 91 ` jt
CITY AYCA.,. c-(`- - STATE 0 ZIP .4�lo
E-MAIL ADDRESS (,,_62ijz/VZ-
PROPERTY9aity(L4 f�e8(L LTELEPHONE NO.OWNER(S) NAME J 6 v P/ t-e j "✓ LL c
d
MAILING ADDRESS //y �� in Sp k /fr-�_
CITY CIA-- eL- STATE (Vit ZIP 9/Zi�U
'E-MAIL ADDRESS �ore 1./. 6( . 66n''
TELEPHONE NO. (5-4a) y g7 7
***PLEASE ANSWER THE THREE QUESTIONS ON PAGE 2***
THE APPLICANT AND PROPERTY OWNER HEREBY DECLARE UNDER PENALTY OF PERJURY THAT ALL
THE INFORMATION SUBMITTED FOR THIS PPLICATION IS TRUE AND CORRECT.
(T/ Z /2-0/�
APPLICA •IGNA 1 • DA
114 7(/S(/2e/t
PROPER OWNER'S SIGNATURE DATE
ACTION TAKEN -- _
❑ APPROVED 41 CONDITIONALLY APPROVED 0 DENIED
CONDITIONS OR REASONS FOR DENIAL: (•ILI rI�EE� SF��CI tZ RET-10 49,0 /IS
QQQ i of -Ili i S AP Plc)VAL_
BY: L-7T— DATE: 2 /1 T Ill EXPIRATION: —
THERE IS A TEN(10)DAY APPEAL PERIOD FOR THIS APPLICATION APPEALS MUST BE SUBMITTED IN WRITING TO THE
COMMUNITY DEVELOPMENT DIVISION WITH A$600.00 APPEAL FEE BY P.M ON
DATE FILED J 112 4( ( I Y RECEIPT NO. 3 0 PAID IC(5 J°RECEIVED BY L-
THE -1- 2/17