TRE2017-00034 City of Tigard, Oregon • 13125 SW Hall Blvd. • Tigard, OR 9722341
TIGARD
05/08/2017
August Peverly
15532 SW Pacific Hwy
PMB 304
Tigard, OR 97224
Re: Tree Removal Permit Record Number: TRE2017-00034
Dear August Peverly:
On 05/08/2017 you submitted an application for tree removal at 12912 SW VILLAGE
PARK LN. Your application specified that:
2 Chanticleer Pear
is/are proposed for removal. Based on the information supplied on your application,
this is a simple tree removal permit request.
City staff has reviewed your application and based on the relevant approval criteria in
the Urban Forestry Manual, your application has been:
Approved, no replacement required
Approved
This decision is final and valid for a period of up to one year after issuance unless
otherwise specified. Nothing prevents you from submitting another tree permit
application if the conditions and circumstances surrounding this removal have
changed.
If you have any questions, please contact us at arborist@tigard-or.gov or
503-718-2421. Please be sure to reference record number - TRE2017-00034.
Best regards,
Community Planning Division
City of Tigard
RECEIVED
,16 City of Tigard MAY 0 8 2017
COMMUNITY DEVELOPMENT DEPAR"I'MLNI'
e CITY OF TIGARD
• Tree Removal Peri-nit App1Catio TANNING/ENGINEERING
PROPERTY INFORMATION
REMOVAL CRITERIA
Address/location: 12912 SW Village Park Ln,Tigard, OR, United States
If you are applying for a simple review,
your application must address one or
APPLICANT INFORMATION more of the relevant removal criteria for
Name: Jack Blankenship the type of tree you propose to remove.
The removal criteria can be found in the
Address: 12912 SW Village Park Ln Urban Forestry Manual as follows:
City/state: Tigard, OR Zip: 97223 •Street Tree:Section 3
Phone: 503-524-5669 Email: blblankenshi •Median Tree:Section 5
p@yahoo.com
•Sensitive Lands Tree:Section 6
Owner: gSamc as applicant •Development-required Tree:Section 7
•Urban Forestry Fund Tree:Section 8
CONTRACTOR/ARBORIST INFORMATION •Heritage Tree:Section 9
Name: Evergreen Tree Services •Documentation(e.g. arborist report,
photographs,site plan,tree risk
ISA/CCB#: /199579 Expiration date: 10/10/2019 assessment form,etc.)of the
Address: 15532 SW Pacific Hwy, PMB#304 conditions described must be included.
Tree replacement is required,unless
City/state: Tigard OR Zip: 97224 otherwise stated in the approval.
Phone: 503-625-4595 Email: office@evergreentsl.com
Contact person: August Peverly
REQUIRED SUBMITTAL ELEMENTS
TREE REMOVAL INFORMATION—to be completed by applicant A Owner's Signature/Written Authorization
Tree species: Flowering Pear Num.of trees: 2 Site/PlotPlan(show koes}tion&spode,
Tree location: Planting Strip(frontyard) of irce,2 copie}
Documentation(see removal criteria)
Reason(s) for Removal suing Fee(complex only)
REVIEW PROCESS
.:. ....: _....: ."•.:..:......_ :� . ,,:::._ ...,._»_ '; ,..._.., T' Sim le '
P 0 Gompleit
❑ Tree is a hazard ❑ Removal required for approved
OPC❑ 'Tree is man advanced state land use or building permit Fee(complexonla)
of decline ❑ Tree is deadr E go14_ � '
Case ltio..
❑ Location conflicts with ' Roots are causing damage Related•Case No(s).
TSP project
Tar I.or ID:Thinningnecessary to protect X513315/] � �
❑ Species is on nuisance tree List other trees
❑ Tree is infested with Application accepted: •
pests ❑ Location does not meet
or disease planting standards Ey: LS Date:
❑ Tree has sustained physical ❑ Recommended by fire marshal Application determined ctitnplete:: •
damage By L5 • Dater
• ttiv;ii rsv�BiuAiihiegket, Rev.12/11/a44
Continued on reverse-for complex review see page 2
City of Tigard • 13125 SW flail Blvd. • Tigard,Oregon 97223 • www.tigard-or.gov • 503-718-2421 • Page 1 of 2
coMPt,E%REVIEW PROCESS check
WPI>gi+k v411;16.44 pmposai sueakmuv)
❑ Blocking views or solar access ❑ Undesirable species ; ❑ Other(explain below)
I I
APPLICANTS
To consider an application complete,you will need to submit ALL of the REQUIRED SUBMITTAL.ELEMENTS
as described on the front of this application in the"Removal Criteria"box.When the owner and the applicant are different
people,the applicant must be the purchaser of record or a lessee in possession with written authorization from the owner
or an agent of the owner.The owner(s)must sign this application or submit a written authorization with this application.
THE APPLICANTS) SHALL CERTIFY THAT:
• The above renu st does not violate any deed restrictions that may be attached to or jtnpusrd upon the subject pmpem
• If the application is granted,the applicant will exercise the rights granted in accordance with the terms and subject to all the
conditions and limitations of the approvaL
• All of the above statements and the statements in the plot plan,attachments,and exhibits transmitted herewith,are true;and
the applicants so acknowledge that any permit issued,based on this application,may be revoked if it is found that any such
statements are false.
• The applicant has read the entire contents of the application,including the policies and criteria,and understands the
requirements for approving or denying the application.
SIGNATURES of each owner of the subject property required.
Applicant's signature Print name Date
•
r
leis signature Print name Date
Owner's signature Print name Date
Authorized agent's signature Print name Date
TREE REMOVAL PERMIT APPLICATION
City of Tigard • 13125 SW Hall Blvd. • Tigard,Oregon 97223 • wwwtigard-or.gov • 503-718-2421 • Page 2 oft
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