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APPLICATION .. Total Project Cost Estimate: City Codes Accessed via Website www.boynton-beach.org , www.amIegaI.comlboynton_beach-fl.us CITY OF BOYNTON BEACH, FLORIDA PLANNING & ZONING DIVISION MINOR LANDSCAPE PLAN MODIFICATION This application must be filled out completely and accurately and submitted to the Planning and Zoning Department. Incomplete applications will not be processed. I. GENERAL INFORMATION: 1. (a_.tcal B~V HOR Project/Business Name & Street Address 2. Applicant's Name & Address (person or business entity in whose name this application is made): (o".st~1 \ 0 Phone: 9 , 4 .. J~~ 0 3o~J. Uo R 1...11. W...thl F . "3)'1''7 Fax: q'Li ..g'l.at Proposed Landscape Plan - 60 % Native species required for Replacement Trees. a. Detailed description of new landscape plan showing all tree species. b. Symbol for trees removed. c. Total caliper inches of trees removed. d. Symbol for tree replacements. e. Total caliper inches of replacement trees. Is this work the result of a code enforcement action? V""' Yes _No Name of citing code enforcement officer: W~. H~.. W. bb Do you require a permit for other site work (i.e. Irrigation)? _Yes ~ No Name of Removal Company: JOt> Bu~(,h L.,,,L",p\I\J R E M o V A L Qty Species Height Trunk Caliper MonthN ear of Removal Total Tree Caliper Inches ..... ..... ..... ..... ..... Start of Removal: MonthlYear: Completion of Removal: MonthlYear: Gross Time Frame for removal: Only 9..1 PJ"llh R.",.,.l onl rltt\ff-l/J + 6 31/1- h".,k ; n ( ( 0 rw. p 1.1 h 0 . PI... ./taly s~h^:HtJ! Minor Landscape Plan Modification Application CALL FOR INSPECTION UPON START OF REMOVAL: 742-6265 Name of Replacement Company: Or\5lfr< ~se:a.pL 10' G,.",~ L.,J6'1Il'~l\~ R E P L A C E M E N T Qty Species Height Trunk Caliper Month Near of Planting Total Tree Caliper Inches -.~-...... ..... Start of Planting: MonthlYear: Completion of Planting: MonthlYear: Gross Time Frame for Replacement: Call for inspection upon start of Replacement: 742-6265 ALL CONTRACTORS HIRED FOR SERVICE MUST HA VE OCCUPA TIONAL LICENSE IN THE City Of Boynton Beach AND PROVIDE PROOF OF INSURANCE. IOL# 2 Minor Landscape Plan Modification Application VI. CERTIFIf' A TION (I) (We) understand that this application and all papers and plans submitted herewith become a part of the permanent records of the City of Boynton Beach. (I) (We) hereby certify that the above statements and any statements or showings in any papers or plans submitted herewith are true to the best of (my) (our) knowledge and belief. This application will not be accepted unless signed according to the instructions below. !ll..J W.ILA f.. !~. 13...1.f(...I.It;.~ Signature of Owner(s) or Trustee, or Authorized principal if property is owned by a corporation or other business entity. m"l, Wtlvh 9J'~/v7 Date Print name or Letter of Authorization from Property Owner Fee Schedule Estimated Value of Improvement: < $5,000.00 = > $5,001.00 = $500.00 $100.00 $200.00 Inspection Deposit: Two separate checks are required. The Inspection Deposit fee is refundable upon completion of a successful final inspection (no later than 60 days from commencement). In the event that the applicant fails to call for a timely (60 days) final inspection, the deposit amount will be forfeited and an inspection will be completed by the forester at that time. 3 The City of Boynton Beach DEVELOPMENT DEPARTMENT PLANNING AND ZONING DIVISON 100 E. Boynton Beach Boulevard P.O. Box 310 Boynton Beach, Florida 33425-0310 TEL: 561-742-6260 FAX: 561-742-6259 www.boynton-beach.org INSPECTION DEPOSIT REFUND Date: ~/7h~ Site: c.t2~.6~ ~ Address: ..$..~...F.~ ~~ Property Owner: e~.~ ~~/j- Contractor: ..... ...."....,. ,...,.... ...., I, n~ uk./e,Z , acknowledge receipt of the inspection deposit refund, check #330 drawn on the account of said Contractor in the amount of$500.00 for the above- referenced site. m~I~~J;/ It!' ;; . Print Name Signature ~ e/" -e... C Wa-i-e Planning & Zoning Print Name ~ C c,.~ignature Coastal Bay HOA c/o Phoenix Management Service 3082 Jog Road Lake Worth, FL 33467 Bank Atlantic 330 **** FIVE HUNDRED AND 00/100 DOLLARS TO THE ORDER OF [:,1',11 /',hl!', )I,JIJ! 111000330111 1:21;708371;31: 001;.803 City of Boynton Beach -. =~) FACSIMILE CITY OF BOYNTON BEACH City Hall, West Wing 100 E. Boynton Beach Blvd. P.O. Box 310 Boynton Beach, Florida 33425 (561) 742-6260 (561) 742-6259 Fax From the office of Planning & Zoning TO: 1J1a-rA tJfkl- --A ~t~ FAX: 9~4-<673/ FROM: DA TE: JtJ-2-0'7 NUMBER OF PAGES: (including cover) ::L RE: ~ &2y /'d~ ~ U ~ /~ /rh~ I--/u- ~~~ . ~ &~aQ'>~cUl :tt:- ttducd/y /IHJ ~ 41zUe i:1 ~ . d ~ ~. -:Iv ~ A.-n~ ft5 ~ I/~. r~ ~l ~ IP q 7/~ j~V7Y /<;1 jltJ?I>J. 7.AtU ~ tI UJ 742.-/,3&,0 J:\SHRDATA\Planning\Planning Templates\P&Z Fax\P & D Blank Fax.dot If you receive this fax in error, or experience trouble with transmission, please notify our office immediately, at (561) 742-6260. Thank you.