APP-Tree
100 NW 1st Avenue Delray Beach FL 33444
(561) 243-7200 Fax: (561) 243-7221
Website: www.delraybeachfl.gov
TREE/PALM/VEGETATION REMOVAL
PERMIT APPLICATION
PROPERTY CONTROL #: ____-____-____-____-____-____-____
FOR OFFICE USE ONLY:
PLEASE PRINT:
JOBSITE ADDRESS
PROPERTY OWNER NAME
HOME PHONE ( ) CELL (____) _____________________
PROPERTY OWNER ADDRESS
CONTRACTOR (COMPANY) NAME
CONTRACTOR (COMPANY) ADDRESS
CITY ST ZIP
BUS. PHONE ( ) CELL (____) ______________________
E-MAIL FAX (____) ______________________
NOTE: PERMIT EXPIRES IF WORK IS NOT STARTED WITHIN 180-DAYS OR IF ACTIVITY LAPSES FOR 180 DAYS. PLANS
MUST BE ON THE JOB SITE FOR ALL INSPECTIONS. FINAL INSPECTION IS REQUIRED ON ALL PERMITS.
NUMBER OF TREES TO BE REMOVED:
NUMBER OF PALMS TO BE REMOVED:
REASON FOR REMOVAL
COMPLETE FOR VEGETATION REMOVAL ONLY:
NUMBER OF ACRES:
TYPES OF SCRUB VEGETATION ON PROPERTY:
CONDITIONS OF PERMIT:
__ _ _ _ _ _ _
____ _ _ _ _
OR
SIGNATURE OF QUALIFIER CONTR. REGISTRATION # WORKERS COMP # EXEMPT (FID /FEIN) #
STATE OF _______________________________________________________________
COUNTY OF _____________________
The foregoing instrument was acknowledged before me by means of [ ] physical presence or [ ] online notarization
this __DAY_____ day of _____MONTH_____________, __YEAR___ by _______________________________________
(Printed Name of Above Signatory)
______________________________________
Signature of Notary Public – State of Florida (NOTARY SEAL)
BLDG PERMIT #:
TREE PERMIT #:
PERMIT FEE:
PLAN CHECK FEE:
MCR #:
********************************
APPROVALS:
LAND: DATE:
Personally Known _____
OR
Produced Identification _____
Type of Identification Produced
_____________________________
REV 5/2023