Transcription of San Antonio, TX 78204 TREE AFFIDAVIT …
1 A/P#: PLAT#: city of San antonio Development Services Department 1901 S. Alamo San antonio , TX 78 204 tree AFFIDAVIT APPLICATION (No Protected T rees t o be Harmed or Removed) MAJOR/MINOR: Inspector s initials: Reviewer s initials: Date: Date: (Office Use Only) Pass Fail Comments: Approved Denied Comments: Applicant Name: Applicant Information Company Name: Phone #: Address: Fax#: city : Email: State: Zip: Name: Address: Owner s information (if different than applicant) Phone: city : Fax: State: Zip: Project Name: Project Information Unit: Plat: Project Address/Location: Project Type: Residen tia l # lots Non-Residential # Outside city Limits: ac res Public Funds: Yes No Yes No Class of Work: Site Work Platting New Structure Geotech Addition(>2500 ft ) Parcel Key: ( ) (Parcel K ey must be included) Type of Application and Review Please note.
2 Applicant shall provide habitat compliance form as defined in section 35-B133 of the UDC for properties with or more acres. Please mark the appropriate box for review (ONLY MARK ONE BOX): 1. Site has no protected Trees, Significant Trees, Heritage, or Historic Trees as defined in the UDC (Aerial photo required); or 2. Site has Protected Trees, but this work will in no way cause damage to or the destruction of said trees; I understand such is a direct violation of the provisions of the UDC (Aerial photo or tree Survey required and site plan showing limits of construction/ building footprint, if available). AFFIDAVIT I, (agent/owner), certify that I am aware of Article V, 35-523 of the and all related a ppendices regarding tree Preservation and agree to adhere to the requirements including any additional fees d etermined to be owed to complete this permit. State of Texas ) ) County of Bexar ) Signature Before me, the undersigned authority on this day personally appeared known to me to be the person whose name is signed t o the foregoing AFFIDAVIT and sworn by me, state under o ath that all of the facts therein set forth are true and correct.
3 Sworn to before me, this _day of , 20 . Notary Public in and for the State of Texas For ms and add itiona l information ca n be foun d at: ht tp://sanant oni o. gov/DSD/Construc Development Services Depa rtment / March 2018
