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Tree Removal Tree Pruning Application 2022

This document contains a tree permit application form for Campbelltown City Council. The form requests information about the property owner, contact details, site details including location of trees, details of the specific trees for removal or pruning, supporting documents that may be required, and instructions for lodging the completed form. Property owners must provide consent for council officers to enter the property and inspect trees. All information provided must be true and correct.

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Gulraiz Humayoon
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28 views

Tree Removal Tree Pruning Application 2022

This document contains a tree permit application form for Campbelltown City Council. The form requests information about the property owner, contact details, site details including location of trees, details of the specific trees for removal or pruning, supporting documents that may be required, and instructions for lodging the completed form. Property owners must provide consent for council officers to enter the property and inspect trees. All information provided must be true and correct.

Uploaded by

Gulraiz Humayoon
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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OPERATIONS

TREE PERMIT APPLICATION FORM


Environmental Planning and Assessment Act, 1979
The information requested by Council on this form may constitute personal information under the Privacy and Personal
Information Protection Act 1998. Council is allowed to collect the information from you to consider this matter. Supplying this
information is voluntary. However if you cannot or do not wish to provide the information, we may not be able to consider the
matter. If you need further details, please contact the Privacy Officer, Campbelltown City Council, cnr Queen and Broughton
Streets, Campbelltown.
PLEASE REFER TO COUNCIL'S TREE MANAGEMENT WEBPAGE
BEFORE COMPLETING THIS FORM

Application Number: TA / Fees Paid $ 158.00


Name
Owner 1 Address
Phone Number
Name
Owner 2 Address
Phone Number
Agent’s Details and Authority (if applicable)
Property Owner

As owner(s) of the land to which this application relates, I/we:


Consent

 Consent to this application


Part 1:

 Consent to authorised Council officers or agents entering (without prior notice) the land to carry out
inspections.
 Declare that all information given is true and correct to the best of our knowledge
 Understand that if the application is incomplete, the application may be delayed or rejected.
 Understand that Council may request additional information.

This form must be signed by all owners of the land or by their legal representatives. If there are more
than two owners please attach separate authorisation. If the owner is a Company or Owners’
Association, this must be signed by a Director or Secretary or authorised delegate and under common
seal. If an agent is lodging then a copy of their authority must be provided.

Owner 1 Signature Date

Owner 2 Signature Date

Contact Name:
Applicant Details

Company Name (if applicable):


ABN (if applicable):
Part 2:

Postal Address / DX:

Phone: Alternative Phone:


Email:
DO NOT USE THIS FORM FOR A TREE THAT POSES A RISK TO LIFE OR PROPERTY.
PLEASE USE COUNCILS DEAD, DYING OR DANGEROUS TREE APPLICATION FORM INSTEAD

DATA AND DOCUMENT CONTROL


Customer Service Revised Date: 28/06/2022 Page 1
Docset: 1497718 Review Date: 28/06/2025 Version: 25
Property Address:
Nearest Cross Street:

Site Details
Part 3
Lot: DP: Section (if applicable):
Will it be necessary to make special arrangements to inspect the site? YES NO
(eg security, dogs)
If YES, contact name: Contact Phone:
Mark on the site plan below the location of the trees to be inspected with a cross (x) and
number accordingly. Please also mark the driveway on the plan.
Tree Details
Part 4:

Please complete ALL information in the table below.


Prune / Approx
Tree Remove Height Common Name Scientific Name Reason for Removal / Pruning

1
2
3
4

Note: This form can only be used for up to four trees.


Are any of the trees to be pruned or removed more than 10m in height?
YES NO
Supporting Information

If YES, you must provide a report from a qualified Arborist.


Is your reason for removal because the tree is damaging pipes?
YES NO
If YES, you must provide a report from a licensed Plumber.
Part 5:

Is your reason for removal because the tree is damaging a building?


YES NO
If YES, you must provide a report from a qualified Structural Engineer.
Have you applied for a Permit or Development Application to remove trees in the last
5 years?
If YES, What was the Application Number?
YES NO

How many trees have been removed?


Address this application to: How to contact us:
General Manager Phone: (02) 4645 4000
Lodging this Form

Campbelltown City Council Email: [email protected]


Fees:
You can send the application to us by:
Mail: PO Box 57, CAMPBELLTOWN NSW 2560 Please refer to Council’s Fees and Charges located on
Council’s website.
DX: DX5114, CAMPBELLTOWN NSW
You can pay by cash, credit card or cheque payable to
Courier or Personal Delivery: ‘Campbelltown City Council’
Cnr Queen Street & Broughton Street Do not send cash in the mail
Please complete a Credit Card Authorisation if required,
CAMPBELLTOWN NSW which can be downloaded from Council’s website:
Email: [email protected] www.campbelltown.nsw.gov.au/formsandpolicies

DATA AND DOCUMENT CONTROL


Customer Service Revised Date: 28/06/2022 Page 2
Docset: 1497718 Review Date: 28/06/2025 Version: 25

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