OFFICE USE ONLY (To be completed after the application has been reviewed by Parks & Forestry Operations)

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1 Street Address. CTS No. CITY OF VAUGHAN TREATMENT OF ASH TREES ON MUNICIPAL PROPERTY BY RESIDENTS APPLICATION FORM OFFICE USE ONLY (To be completed after the application has been reviewed by Parks & Forestry Operations) Permit No.: Process. Receipt No. N/A Processing Fee: N/A Received By: Date: Approved: Denied: Method of Payment: N/A CHECK LIST 1. Contractor Information (a) Name of licenced company (b) Recommendation 2. Pictures (2) Pictures required per tree: Close up of the tree Overview of the tree in proportion to the lot. APPLICATION # The personal information on this form is collected and will be used for the purposes of this application only. This application may contain personal information as defined under the Municipal Freedom of Information and Protection of Privacy Act. This information will be used to process this application and for administrative purposes related to the treatment of Ash Trees on Municipal Property by resident. Questions related to the collection of this information should be directed to the Municipal Freedom of Information and Protection of Privacy Act Coordinator, 2141 Major Mackenzie Drive, Vaughan, Ontario, L6A 1T1, (905) Extension

2 Instructions for Completion of Application: 1. This application is applicable to TreeAzin treatment of City trees on municipal property through a licensed contractor, at the resident s expense. 2. Application form to be completed by applicant. Print CLEARLY. Incomplete applications will not be processed resulting in delays. 3. Application processing time: days. 4. Municipal address must include street name and number. (911 numbers for rural location) 5. Provide photographs of the tree(s) being treated. Photos are to include a close up and a photo taken at a distance providing context on the site. 6. Provide a recommendation from the licensed contractor for the tree(s) being treated with TreeAzin. 7. Provide written authorization from the owner if this application is signed by an applicant other than the owner, or by an agent. 8. Submit this application and supporting documentation to Parks & Forestry Operations, Joint Operations Centre located at 2800 Rutherford Road, Vaughan ON L4K 2N9 or scan & to: parks@vaughan.ca 2

3 APPLICANT INFORMATION 1. Municipal address of subject property: 2. Name of Applicant/Agent: 3. Mailing Address of applicant: 4. Telephone: Work No.: Fax: address: 5. Name of Registered Owner (if different from above): 6. Mailing address of Owner (if different from above) 7. Name of Licensed Contractor: 8. Licensed Contactors Contact Information: 9. Number of trees being treated with TreeAzin. 10. Please specify number of Ash trees and diameter of trees subject to TreeAzin treatment Ash Tree Tree Diameter (cm) 11. Utility Clearance Obtained (check all applicable): Not Applicable PowerStream Ontario Hydro Bell Gas Water Cable tv This information must be supported by a licensed Contractor s recommendation and/or approved by Manager. Declaration I hereby declare that the statements made by me upon this application are, to the best of my belief and knowledge, a true and complete representation of the purpose and intent off this application and authorize City of Vaughan staff to enter the property for inspection purposes for processing this application. Signed at the City of Vaughan this day of, 20 Signature of Applicant: Please print name: 3

4 Agreement for Contractors to Perform Treatment of Trees on Municipal Property The City of Vaughan ( City ) regulates the planting, care, maintenance, and protection of trees on City Highways/Roads or street allowances ( City Streets ) and, through its associated policies, ensures the sustainability of the urban forest. The Manager of Parks Services is authorized to care for and maintain or cause to be cared for and maintained, any trees located on any City Street ( City Trees ). The Manager may authorize work to be performed on City Trees by an approved professional contractor that has been retained by an adjacent private property owner. In consideration of the permission granted herein by the City for the undersigned qualified contractor ( Contractor ) to undertake work on City Trees as set out in Treatment of Trees on Municipal Property by Resident Application Form attached hereto ( Work ), the Contractor and the undersigned property owner acknowledge and agree as follows: 1. The property owner(s) signing below is/are the registered owner(s) of the property municipally known as. (please insert address including postal code) 2. The property owner and Contractor acknowledge and agree that all Work is to be undertaken and completed at the property owner s sole risk and expense and that there shall be no compensation, remuneration or reimbursement by the City. The property owner further acknowledges and agrees that any City Tree shall remain the property of the City notwithstanding any Work being undertaken and/or completed by the property owner. 3. Contractors shall be licensed by Bio-Forest qualified applicator to provide TreeAzin treatments. 4. TreeAzin injections must be authorized by the City s Manager of Parks Services prior to treatment. 5. The Contractor shall not, under any circumstances, work on or near energized apparatus unless express written approval has been given by PowerStream and/or Ontario Hydro, as applicable. Confirmation of approval given by PowerStream must be provided to the Forestry Supervisor upon request, prior to the commencement of the Work. 6. The Contractor shall be qualified to perform all Work and shall carry out all Work in a good and professional workmanlike manner in accordance with the City s latest standards and requirements and all other legislative requirements including without limitation, the Electrical Utility Safety Association Rules, the Occupational Health and Safety Act, the Highway Traffic Act, the Workers Compensation Act, the Pesticides Act and the Pest Control Products Act. The Contractor shall obtain all O: GUIDELINES & POLICIES\Guidelines For Treatment of Trees on Municipal Property

5 necessary permits and licenses and pay all required fees and shall also provide all notices as required by law or policy prior to commencement of the Work. 7. The Contractor shall be licensed and trained by BioForest Technologies Inc. and only use approved injection techniques. 8. The property owner and Contractor hereby agree to indemnify and keep indemnified and save harmless the City and each of its officers, employees, servants and agents from and against all actions, suits, claims, executions and demands which may be brought against or made upon the City, its officers, employees, servants and agents and from all loss, costs, charges, damages, liens and expenses that may be paid, sustained or incurred by the City, its officers, employees, servants and agents by reason of or on account, or in consequence of the execution and performance of the Work or of the non-execution or imperfect execution thereof. 9. The property owner hereby waives any and all claims or causes of action that the property owner may have against the City that may arise as a result of the Work being undertaken or completed by the property owner and/or Contractor. 10. The property owner understands that; treatment of City Trees with TreeAzin may not necessarily save the City tree. Because the extent of internal damage cannot be quantified, long term treatment may not be successful the City will continue to maintain the City tree in accordance with applicable City standards and policies the City tree must be treated every 2 years or the City tree will die the City tree may still die/fail due to structural issues, storm damage and other disease. O: GUIDELINES & POLICIES\Guidelines For Treatment of Trees on Municipal Property

6 Name of Property Owner(s): (Please print) I/We am the Registered Owner of (Please insert address) Signature: Witness: Name of Contractor (corporation/company): Name of Signing Officer: (Please print) Signature: Witness: (Required if Contractor is not incorporated) I/We have authority to bind the corporation/company. O: GUIDELINES & POLICIES\Guidelines For Treatment of Trees on Municipal Property

THE CORPORATION OF THE MUNICIPALITY OF POWASSAN BY-LAW NO

THE CORPORATION OF THE MUNICIPALITY OF POWASSAN BY-LAW NO. 2004-20 Being a By-Law to establish policies for the use of unopened road allowances for motor vehicle travel WHEREAS this Municipality is the