EXHIBIT C
   CITY OF GREENVILLE, OHIO
   TREE PLANTING PERMIT
Date:____________________________            Application Number:__________________
This is to certify that   _______________________________   Property Owner
         Name                  Yes_____   No ____
         ______________________________      ____________________
         Mailing Address            Phone No.
Location of Problem:   ___________________________________________________________
Applicant has registered with the City Engineer for the purpose of:
   _______      Planting of tree in right-of-way.*
            Number and type of tree(s) to be planted:_______________________
            Method of planting:___________________________________________
   _______   Maintenance of tree in the right-of-way. Kind of treatment: spray, prune, trim
            Number and type of tree(s):___________________________________
            Any chemicals to be used:_____________________________________
   _______   Removal of tree in right-of-way and the replanting of a new replacement tree in the right-of-way.*
            Number and type of tree(s) to be removed:________________________
            Number and type of tree(s) to replace:____________________________
   ________      Other.
Reason for request   ___________________________________________________________
*   This application must be accompanied by a plat drawn to scale showing the location of proposed planting within the right-of-way, making sure to show the distances from each tree, sidewalk, street, and any street corner.
Note: Applicant assumes any and all liability for loss or damages resulting from the maintenance or removal of said tree(s).  Replacement trees must be planted within six (6) months from the date the Tree Commission or Safety Service Director grants approval of the permit.
                              _____________________________________
                              Signature of Applicant
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   DISPOSITION - TO BE COMPLETED BY TREE COMMISSION MEMBERS
         OR SAFETY SERVICE DIRECTOR
   ___ Approve   ___ Disapprove   _____ City participation
Date of Approval: ____________   Date work is to be completed: ______________________
Inspected By:   _____________________________      Date:   ________________________
Comments on Decision:   ______________________________________________________
_______________________________________________________________________________
(Ord. 11-56.  Passed 6-7-11; Ord. 18-77.  Passed 7-17-18.)