INCORPORATED VILLAGE OF BAYVILLE

APPLICATION FOR TREE REMOVAL PERMIT

(Pursuant of Chapter 72 of the Code of the Village of Bayville)

PERMIT NO.
APPLICATION FEE: $25 PLUS
$10 PER TREE
SECTION BLK.
LOT(S) ZONE
Application to be filled out in duplicate. Indicate on plot plan below location of tree(s) to be removed in respect to property and/or street lines and any structures on property. Two copies of property survey must accompany this application.
Owner NAME
ADDRESS
TELEPHONE NO.
Contractor NAME
ADDRESS
TELEPHONE NO.
Insurance WORKMAN'S COMPENSATION POLICY NO.
AGENT
DATE OF EXPIRATION
PURPOSE OF TREE REMOVAL
___________________ Signature of Applicant