City f Lndn Tree Prtectin By-Law C.P.-1515-228 Tree Prtectin Area Permit Applicatin Cemetery r Glf Curse Planning Services - Urban Frestry 267 Dundas Street, 3rd Flr Lndn, Ontari N6A 1H2 Telephne: 519-661-CITY (2489), ext. 4457 E-mail: treeprtectin@lndn.ca Instructins Fee Schedule 1. This prcess pertains t an applicatin t Injure and/r Destry a Tree(s) within a Tree Prtectin Area as defined by Schedule D f the By-law, as may be amended frm time t time, in a Cemetery r n a Glf Curse. 2. There are n applicatin fees fr trees in a cemetery r glf curse. City f Lndn cntact infrmatin Please cmplete the fllwing infrmatin. If yu require assistance, City staff may be cntacted by telephne at 519-661-CITY (2489), extensin 4457 r by e-mail t treeprtectin@lndn.ca. Once this applicatin has been cmpleted, please submit it with payment by ne f the fllwing ptins: 1. Scanned and sent by e-mail t treeprtectin@lndn.ca (payment will be required prir t the applicatin being cnsidered cmplete). 2. Mailed t Urban Frestry, City f Lndn, 267 Dundas Street, 3rd Flr, Lndn Ontari N6A 1H2. 3. In persn at 267 Dundas Street, 3rd Flr, Lndn Ontari, between the hurs f 8:30 a.m. and 4:30 p.m. Mnday Friday After Submissin Upn receipt, yur applicatin will be reviewed and yu will be cntacted by City staff. By submitting this applicatin, the City will deem yu t have cnsented t a member f City staff visiting the prperty between 8 a.m. and 5 p.m. (Mnday - Saturday) t inspect the Tree(s), whether yu are present r nt. Every effrt will be made t cnduct the visit at a mutually cnvenient time. T assist staff, it wuld be helpful if yu culd attach clured flagging tape r a piece f material - either arund the trunk r arund a branch - at a visible height t each Tree subject t this applicatin. Please d nt mark the Tree in any way which culd cause injury, such as slashing bark frm the Tree. Right t Appeal The Applicant has the right t appeal and request a Hearing with a Hearings Officer if the Municipality fails t make a decisin n an applicatin within 60 days after a cmplete applicatin is received by the City Planner. A request by an Applicant fr a Hearing shall be made in writing and filed with the City Clerk. The request shall cnsist f a ntice f appeal and must cmply with the requirements set ut in Schedule 1 f the City s Hearings Officer By-law A-6653-121. www.lndn.ca
City f Lndn Tree Prtectin By-Law C.P.-1515-228 Tree Prtectin Area Permit Applicatin Cemetery r Glf Curse Planning Services - Urban Frestry 267 Dundas Street, 3rd Flr Lndn, Ontari N6A 1H2 Telephne: 519-661-CITY (2489), extensin 4457 E-mail: treeprtectin@lndn.ca APPLICANT INFORMATION Cmplete the fllwing infrmatin. All cmmunicatins will be directed t the Primary Cntact with a cpy t the Landwner if different. Nte: If additinal space is required fr Landwner(s) infrmatin, please attach a separate sheet cntaining said infrmatin. Landwner(s) (Attach infrmatin with additinal Landwner infrmatin if required) Name Telephne number E-mail address Address City Prv/Territry Pstal cde Applicant (cmplete if the Applicant is different frm the Landwner) Name Telephne number E-mail address Address City Prv/Territry Pstal cde Prfessinal credentials Qualified Persn authrized by the Landwner t file the applicatin (if applicable) Name Telephne number E-mail address Address City Prv/Territry Pstal cde Prfessinal credentials Cntractr implementing the wrk Business name Telephne number E-mail address Address City Prv/Territry Pstal cde Name f persn ding wrk Prfessinal credentials Primary Cntact Which f the abve is the Primary Cntact? Landwner Applicant Qualified Persn Cntractr LAND SUBJECT TO THE APPLICATION Municipal address Unit number City Rll number Legal descriptin f prperty Lndn Frm n. 1733 (rev.2017.05) www.lndn.ca Page 1 f 3
Subject Tree (if multiple trees, please attach a sheet listing each tree with the same infrmatin as requested belw) Species Diameter at 1.4 metres abve grund level Height (in metres) Cnditin Please make sure yu have identified clearly what it is yu want t achieve, s that staff, when visiting the site, are able t identify the Tree(s) and what yu want t d. If mre than ne Tree is present, please identify each Tree by a unique number (e.g. 1, 2, 3) r letter (e.g. A, B, C) and the species, if knwn. Have yu identified which Trees, where, are t be Injured and/r Destryed? Yes N Have yu attached cnfirmatin by the Qualified Persn f the lcatin, species, size and health f the Distinctive Tree(s) n the prperty? Bundary Tree Is the Tree(s) a Bundary Tree(s)? A Bundary Tree shall have the same meaning as defined by the Frestry Act, R.S.O. 1990 c.f.26. * If yes, have yu included the written cnsent t the applicatin by the adjacent Landwner(s)? Attach r include: A five-year Silvicultural Prescriptin and/r Frest Management Plan, prepared by a Qualified Persn, describing hw the Trees n the Site are t be managed in a sustainable fashin t achieve Gd Arbricultural Practices and Gd Frestry Practices. The reprt will evaluate the basis fr the prpsed Tree Injury r Destructin and identify recmmendatins fr any cnditins t be included in a Tree Prtectin Area Permit that the Qualified Persn believes are necessary t be in accrdance with Gd Arbricultural Practices. Als include a general descriptin f the circumstances that wuld represent a substantive change frm the five-year Silvicultural Prescriptin and/r Frest Management Plan that wuld require a Tree Prtectin Area Permit. Such ther infrmatin deemed necessary by the City Planner. APPLICATION CONSENT Yes Yes * Yes N N N Signature f Applicant By submitting this applicatin, the City will deem yu t have cnsented t a member f City staff visiting the prperty between 8:00 a.m. and 5:00 p.m. (Mnday - Saturday) t inspect the Tree(s), whether yu are present r nt. Landwner's authrizatin (if different frm Applicant) I understand that an Applicatin is being made fr a Permit t Injure r Destry a Tree r Trees frm my land. By signing this Applicatin, I am cnsenting t the Applicatin. I acknwledge that the City Planner will send a cpy f his r her decisin t me. Signature f Landwner Signature f Landwner NOTICE OF COLLECTION OF PERSONAL INFORMATION The persnal infrmatin cllected n this applicatin frm is cllected under the authrity f the Municipal Act, 2001, as amended and the City f Lndn Tree Prtectin By-law C.P.-1515-228 and will be used t assist the Civic Administratin in evaluating the request. The persnal infrmatin will be disclsed t City staff nly n a need t knw basis but it will nt be disclsed t the public unless therwise required by law. Hwever, infrmatin abut the specific Tree(s) and its/their lcatin with respect t this applicatin will becme part f the public recrd. Questins abut this cllectin f persnal infrmatin shuld be addressed t the Manager f Envirnmental and Parks Planning at 267 Dundas Street, 3rd Flr, Lndn, ON N6A 1H2 r by telephne at 519-661-CITY (2489), extensin 4457. www.lndn.ca Page 2 f 3
Fr City f Lndn use nly Applicatin number Date received File handler name Decisin Permit issued Refused Date f decisin Date applicatin deemed cmplete www.lndn.ca Page 3 f 3