No preview available
HomeMy WebLinkAboutPROTECTED TREE REPORT CITY OF ARCADIA IRE 1 6 �3 Z PROTECTED TREE PERMIT ENCROACHMENT INTO A PROTECTED ZONE a 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