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Step One

Address*
Briefly Describe the Proposed Tree Removal*
Applicant Name(s)*
Applicant Name(s)*
List all Property Owners
Daytime telephone:*
Cell:*
Address
(if different from property address)
Filing Requirements*
1. Completed Chevy Chase Village Statement of Appeal for Tree Removal Permit (this form)
2. Denied Chevy Chase Village Tree Removal Permit Application
3. Chevy Chase Village Tree Inspection Report from Village Arborist
4. Surveys, plats landscaping plans, or other accurate drawings showing boundaries, dimensions, and area of the property, as well as the location and dimensions of all structures and trees to be removed
5. Appeal Fee (see fee schedule in Chapter 6 of the Village Code
(Application will not be accepted or reviewed until the application is complete)
Affidavit
I hereby certify that I have the authority to submit the foregoing appeal, that all owners of the property have signed below, that I have read and understand all requirements and that I or an authorized representative will appear at the scheduled public hearing in this matter. I hereby authorize the Village Manager, or the Manager’s designee, the Board of Managers, and members of the Village Tree Committee, to enter onto the subject property for the purposes of assessing the site in relation to this appeal. I hereby declare and affirm, under penalty of perjury, that all matters and facts set forth in the foregoing statement are true and correct to the best of my knowledge, information and belief.
Electronic Signature Agreement
By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.
1. I agree.
Applicant's Signature:*
Date:
Date:
Applicant's Signature:
Date:
Date:
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Step Two

Describe the basis for the appeal
Describe the reasons why the tree removal would not adversely affect the public health, safety or welfare nor the reasonable use of adjoining properties:*
Describe the reasons why the tree removal would not substantially impair the intent and purpose of Chapter 17 of the Chevy Chase Village Code, entitled Urban Forest:*
Describe whether the tree exhibits any of the following criteria: (i) is diseased beyond restoration, insect infested beyond restoration, or injured beyond restoration; (ii) is dead or dying, or in danger of falling; (iii) constitutes a hazard to the safety of persons; (iv) constitutes a hazard to the safety of property; (v) constitutes a hazard and threatens injury to, or would have a negative effect on the health of other trees; (vi) is injurious to or creates a condition injurious to the health of a person, certified to by a qualified medical practitioner:*
Describe the reasons for wanting to remove or destroy the tree(s):*
Describe the reasons, if any, cited by residents who are either in favor of or in opposition to the issuance of the requested tree removal permit:*
If the desired tree clearing is necessary to achieve proposed development, construction or land use otherwise permitted under the Village Code, describe the proposed project and/or land use and any reason(s) why there is no reasonable alternative to the tree removal:*
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Step Three

Describe any proposed reforestation and whether the proposed reforestation includes any trees that meet the Village standards for reforestation (i.e., deciduous hardwood trees that are least 2 ½ inches in caliper at the time of installation and of a species that achieves a mature height of at least 45 feet):*
Describe any hardship that would result if the requested tree removal is denied:*
Describe the reasons why preserving the tree(s) is not desirable because of the age, size or outstanding qualities, including uniqueness, rarity or species specimen, of the tree(s):*
Describe any other relevant matters that you believe would promote fairness and justice in deciding this appeal:*
In authorizing a Tree Removal Permit as a result of this appeal, the Chevy Chase Village Board of Managers may require such conditions, terms or restrictions as it deems necessary in order to protect the public, health, safety or welfare, the reasonable use of adjoining properties and that will substantially effectuate the purpose and intent of Chapter 17 of the Chevy Chase Village Code.
Appeal Fee:
Fee
Quantity
Shipping Cost
Taxable
For Village Staff Use Only:

Leave This Blank:

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Statement of Appeal for Tree Removal Permit

Steps

Step One

Step Two

Step Three

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