NS:

Please print or type to allow for a more accurate processing of your application. Submit the completed application, which must be signed by the property owner, to the Public Works Department, 10800 Red Road, Pinecrest, Florida 33156. Incomplete applications will be returned.

APPLICANT INFORMATION

Property Owner: Property Address: Telephone/E-mail:

Draw a sketch below showing your property, property line, sidewalk, driveway and road. Place an X on the location where you plan to plant the tree(s). Attach a survey of the property, if one is available.

PLANTING REQUIREMENTS

Tree(s) must be planted:  A minimum of six (6) feet from edge of the street pavement;  A minimum of two (2) feet from edge of sidewalk or property line;  A minimum of ten (10) feet from driveways;  A minimum distance apart, as specified by Pinecrest according to tree species;  A minimum of thirty-forty (30-40) feet from existing trees;  A minimum of fifteen (15) feet from street lights and/or traffic signals.

SPECIES, SPECIFICATIONS AND PRICES (Contact for Current Pricing)

Mahogany (Swietenia Mahogoni) 12’ height, 4’ clear trunk, 3” caliper, 25’ distance apart on center

Silver Buttonwood (Conocarpus Erectus Sericeus) 10’ height, 3.5’-4’ clear trunk, 2.5” caliper, 20’ distance apart on center

Live Oak (Quercus Virginiana) 12’ height, 4’ clear trunk, 3” caliper, 25’ distance apart on center

Green Buttonwood (Conocarpus Erectus CV Momba) 10’ height, 3.5’-4’ clear trunk, 2.5” caliper, 15’ distance apart on center

Pitch Apple (Clusia Rosea) 8’ height, 3’ clear trunk, 2” caliper, 10’ distance apart on center

South Florida Slash Pine (Pinus Elliottii) 12’ height, 4’ clear trunk, 3” caliper, 10’ distance apart on center

Royal Poinciana (red) (Delonix Regia) 12’ height, 4’ clear trunk, 3” caliper, 25’ distance apart on center

Green Malayan Coconut Palm (Cocos Nucifera CV Green Malayan) 10’ height, 3.5’-4’ clear trunk, 15’ distance apart on center

Silver Trumpet (Tabebuia Caraiba) 10’ height, 3.5’-4’ clear trunk, 2.5” caliper, 15’ distance apart on center

Winin Palm (Vietchia Winin) 10’ height, 3.5’-4’ clear trunk, 10’ distance apart on center

Gumbo Limbo (Bursera Simaruba) 12’ height, 4’ clear trunk, 3” caliper, 15’ distance apart on center

Florida Thatch Palm (Thrinax Radiata) 5’ height, 10’ distance apart on center

Queen’s Crape Myrtle (Lagerstroemia Speciosa) 7’ height, 3’ clear trunk, 2.5” caliper, 25’ distance apart on center

Apple Blossom Shower (Cassis Javanica) 8’ height, 3’-3.5’ clear trunk, 2.5” caliper, 15’ distance apart on center

Jacaranda (Jacaranda Mimosifolia) 12’ height, 4’ clear trunk, 3” caliper, 15’ distance apart on center

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REMITTANCE

Please indicate the quantity to be purchased and the cost in the appropriate spaces provided below:

Species Quantity Unit Price Total Mahogany Silver Buttonwood Live Oak Green Buttonwood Pitch Apple South Florida Slash Pine Royal Poinciana (red) Green Malayan Coconut Palm Silver Trumpet Winin Palm Gumbo Limbo Florida Thatch Palm Queen’s Crape Myrtle Apple Blossom Shower Jacaranda

PLEASE MAKE ALL CHECKS PAYABLE TO THE VILLAGE OF PINECREST AND SUBMIT TOGETHER WITH THE COMPLETED APPLICATION. FEES FOR STREET TREE PLANTING ARE WAIVED. SPECIES AND PRICES AFFIDAVIT

I, the owner of the above referenced property and as a voluntary participant in the Village of Pinecrest’s Adopt-a-Tree Program, do hereby agree to pay for the cost of (number and species) ______tree(s) and to care for the tree(s) as specified on the attached instructions. The total cost for the tree(s) is $______. I understand that I am responsible for the maintenance of the tree(s) for the life of the tree(s). It is also agreed that the tree(s) will not be removed or relocated for any reason unless approved by the Village of Pinecrest.

STATE OF FLORIDA, COUNTY OF MIAMI-DADE

______Signature of Owner Print Name of Owner

Sworn to and subscribed before me this______day of ______, 20______.

______Personally Known ______Signature of Notary Public - State of Florida or Produced Identification ______Type of Identification: ______SEAL:

OFFICE USE ONLY

Total Amount Paid $______Receipt No. ______

Staff Initials: ______Date Received: ______

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