RT06 - 517 N 22ndRecorded
WASHINGTON COUNTY NEBRASKA
General Filed for record on November 01, 2019 at 09:05 AM
Numerical .—.�.. Instrument No. 2019-03444
Photostat---—.--�.. P Page )
Proofed
Scanned / Carolyn M Stodola, Register of Deeds
Prepared by and after Recording Return to:
Brenda wheeler, City Clerk, City of Blair, 218 S. 161h Street, Blair, NE 68008 (402) 426-6694
DATE OF INSTRUMENT:
CITY OF BLAIR — RIGHT OF WAY TREE PERMIT
Permit #
q Promise o
Date:
Approximate Completion Date:
Fee: $15.00
Site Plan Drawing Attached: / Type of Tree: 4-JI,�,I
Additional Description of pro
PROJECT INFORMATION:
Job Address:
Legal Description (if applicable
Owner: � Pofcc-nO-i Address: zed___ H #:
C
Owner: Address: 5(7 �:) 2-Z, H #:
C #: j Zcjo
TYPE OF ALLOWABLE TREES TO BE PLANTED ON CITY OF BLAIR RIGHT OF
WAY:
1. Street trees are herein defined as trees, shrubs, bushes, and all other woody vegetation on
Municipal right-of-ways, on all streets, avenues, boulevards, alleys, or other transportation
ways within the Municipality.
2. Park trees are herein defined as trees, shrubs, bushes and all other woody vegetation in
public parks and all other public lands owned by the Municipality.
3. Small trees are defined as Crab Apple (small or no fruit only), Golden Rain Tree, Hawthorne
(by special permission only), Hop Hombean, Japanese Tree Lilac, Maple as follows: Amur
Maple, Compectre or Hedge Maple, Tartarian Maple, Callery Pear in variety, and Redbud.
4. Medium trees are defined as Amur Cork Tree, Birch as follows: Monarch Birch, Canoe
birch, River Birch; Buckeye as follows: Ohio or Yellow; Ginkgo, Linden as follows:
Littleleaf and Edmond; Oak as follows: Bur, English, Sawtooth, Shingle, Swamp White,
Pagoda Tree, Yellow Wood.
5. Large trees are defined as Hackberry, Honeylocust (thornless and padles only), Horse
Chestnut, Kentucky CoffeeTree, Maple as follows: Black and Sugar; Oak as follows: Black,
Red, Scarlet, White.
We, understand as the owner of the property, that we, our heirs or our assignees are
responsible for the perpetual care, maintenance and removal of said tree(s), and we agree to
not plant any tree(s) closer than ten (10) feet to a curb or fifteen (15) feet from the shoulder of
the road if there is no curb. We also agree not to plant any tree(s) within six (6) feet of any
public sidewalk, and all tree(s) planted will he in conformance with Section 6-319, 6-319.01, 6-
319.02, 6-319.03, and 6-619.04 of the Blair Municipal Code.
Signature of Owner(s) Date
STATE OF NEBRASKA )
) ss
WASHINGTON COUNTY )
The foregoing instrument was acknowledged before me on �i % , 20jy, by
hf I m Pe r f C— n U-{- , owner(s) of the above stated real property.
GENERAL NOTARY State of Nebraska��
BRENDA R WHEELER NOTARY PUBLIC
— My Comm. Exp, June 20, 2020
My commission expires: &/Z,
For Office Use Only WHENPROPERLY VALIDATED (BEL099 THISIS YOUR PERMIT
Date Permit Paid.' 11-7(lei Receipt Approved by:�4pcvtl�
2019-03444
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