Application Form Fortree Trimming, Cutting, or Relocation

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General Quality Form

SUBIC BAY METROPOLITAN AUTHORITY ECD-RPD-26


ECOLOGY CENTER
Regulatory Bldg., Labitan St. cor. Rizal Highway, Subic Bay Freeport Zone, Philippines 2222 Revision No.: 02
Tel 047.252.4656/4059; Fax 047.252-4157; email: [email protected]
Effectivity Date: 9/16/19

Control No:
REQUEST FOR TREE TRIMMING/TREE CUTTING/TREE RELOCATION

A. Requested by: _______________________________________________ Date of request: _______________________


SBF Locator _______________ SBF Resident Others (specify) ______________Contact No: ___________
B. Address: _____________________________________________________________________________________________
C. Request permit to cut tree/s (specify location of tree/s)___________________________________________________
trim branches of trees (specify location) _______________________________________________
relocate tree/s from ______________________________ to _______________________________
D. Reason/s for the above request: __________________________________________________________________________

__________________________________________ ___________________________________________
Applicant Property Owner
(Printed Name and Signature) (Printed Name and Signature)
E. Available Date/Time for Inspection: ___________________________________

F. Neighbor’s Consent, should a portion of the tree fall on the neighbor’s property:

_________________________________ Date signed: _________________ Tel. No./Mobile No: ________________


Printed Name and Signature of Neighbor
(This portion to be filled out by RPD personnel)

INSPECTION REPORT
A. Date/Time request for Inspection was received: ______________________Received by: ___________________________
B. FINDINGS:
1. Date/Time inspected: _____________________________________________
2. Area Category: Public Residential Commercial Industrial Recreational Others ___________
CONDITION OF TREE
NO. OF DBH MH DURING INSPECTION RECOMMENDED ACTIONS
TREE SPECIES
TREE/S (cm) (m) De- (CUT, TRIM, RELOCATE, TREAT, ETC.)
Dead Live Fallen
cayed

3. Additional Findings / Comments/Recommendations (if any): ________________________________________________


INSPECTED BY: CONFORME:
____________________________________________ ________________________________________
(Inspector/s’ Printed Name/s and Signature/s) Name, designation and signature of contact person
during time of inspection

Noted by: _________________________________________


Division Chief III, Protected Area Division

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