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2. Incomplete applications will not be processed
4. Applicant Name (if different from Property Owner)
6. Address1
8. City
9. State
10. Zip
12. Property Owner Information
13. Same as Applicant?

    1. check if same
15. Address1
17. City
18. State
19. Zip
21. Phone (please provide at least one phone number)
22. Home
23. Work
24. Cell
26. Email
28. Tree Information
30. Tree(s) to be removed:
31. Number
32. Species
33. DBH (in)
    (DBH = diameter at 4 ½ feet above ground)
36. Number
37. Species
38. DBH (in)
40. Removal by MD License Tree Expert only:
41. Contractor
42. MD LTE #
44. Tree(s) to be planted:
45. Number
46. Species
47. Caliper(in)
    (2.5” caliper standard)
50. Number
51. Species
52. Caliper (in)
54. Planting to be done by:
55. Contractor
56. Other
58. Tree Seller
59. Nursery
60. Contact
61. Phone
63. Reason(s) for removal (attach MD LTE / certified arborist’s report and photos if available)

    1. Dead
    2. Severe decay/rot
    3. Pathogen (bacteria/virus)
    4. Insect infestation
    5. Disease (fungal)

    1. Infrastructure damage
    2. Structural damage (tree)
    3. Utilities conflict
    4. Other
64. Other
66. Comments
67. Upload any reports and/or photos
69. I understand that replanting is a condition of removing street trees and that replacement may not be 1:1. I understand that I am responsible for the successful establishment of the replanted trees and that I will be required to replace them if they die within two years after planting.
71. Name*
72. Date*
Leave This Blank:


74. 1. Receive an email copy of this form.
75. Email address

    This field is not part of the form submission.

76. Submit Submit and Print

* indicates a required field