Exempt Tree Works - Removal of Dead, or Immediately Dangerous Trees

Exempt Tree Works - Removal of Dead, or Immediately Dangerous Trees - Private property
Use this for exemptions under Part 3.1 of Councils Tree Management Policy- Trees on Private land- Removal of Dead, or Immediately Dangerous Trees
Council will review the provided information and may be in contact if required. Please note that in incidences where a tree has been or is suspected to have been vandalised, this exemption does not apply. Should council not accept this form as factual, the tree pruning or removal will be treated as tree vandalism and penalties may apply.
Details of the property owner

Property owner is required to retain along with evidence for a minimum of 2 years and to be made available to Council upon request
Title*

MrMrsMissMsOther
Family name (or company)*
Given name/s*
Postal address*
Postcode*
Phone*
Alternative Phone
Email*
example@example.com
Only if a Company or Owners Corporation:
Contact Person
Location and title description of the property

To accurately identify the land on which the tree is located
Unit No*
House No*
Street*
Suburb*
Lot(s)*
Section*
Deposited Plan(s)*
Strata plan*
Other
Qualified arboricultural assessment

Qualification: AQF level 5 in Arboriculture, copy of qualifications are to be attached. All details are to be completed in full and signed to be a valid document. All names must be person’s legal name. Arborist is to provide the tree owner this document and all relevant evidence and keep a copy
Business name*
Name of Arborist*
Phone*
E-mail*
example@example.com
AQF Level in Arboriculture*
Certificate No*
Course Provider*
As a qualified arborist I have;
1. Carried out a thorough inspection of
Number of tree/s*
Tree species 1*
Tree species 2*
Tree species 3*
Tree species 4*
Tree species 5*
2. Determined that*

a) the tree/s structure is significantly compromised, and therefore poses an imminent and unacceptable risk to life and property. It is my recommendation that immediate removal is the minimum actions necessary to manage the risk.b) the tree/s structure is significantly compromised, and therefore poses an imminent and unacceptable risk to life and property. It is my recommendation that immediate pruning of …………% of the trees canopy is the minimum actions necessary to manage the risk.
Recommended percentage of tree's canopy to prune to manage risk
3. Assessed each tree for hollows or other habitat
Assessment of each tree for hollows or other habitat*

a) found no evidence, orb) arranged for local wildlife group (e.g., Wires) to attend during removal, and
4. Provided with this document
- A documented tree inspection, including tree condition assessment, works methodology and a complete tree risk assessment i.e. QTRA, TRAQ, in accordance with industry best practice.
- Supporting evidence, which is to include clear and relevant photographs of the tree(s), any defects, failed sections and branches.
Provided documents*

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5. Provide a site plan below to show where the tree/s location in relation to the dwellings and boundaries.
The following information is provided to support this form at the above address. Relevant information regarding disclaimers, photos, risk or hazard assessment, and any other evidence to support the application, is attached to this form.
Site Plan with Tree/s located in relation to structures include where street is located.

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Condition of tree/s (also attach Risk Assessment)
Why tree/s considered an Imminent Risk to Human Life or Property? What alternatives were considered and review of options.
Name of Arborist*
Signature of Arborist:*

Clear
Date*

DayMonthYear
Date
Name of person who owns the Tree/s*
Signature:*

Clear
Date*

DayMonthYear
Date
Only if a Company or Owners Corporation:
Company or Owners Corporation authorised person name
Company or Owners Corporation authorised person name
Company or Owners Corporation authorised person signature

Clear
Owners Corporation seal or attach letter of authority to Act

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Privacy Disclaimer:
Your personal information is being collected by Council in accordance with applicable legislation. The provision of your personal information is voluntary, however the information assists Council in the delivery and management of the subject request, and / or as required by law.

Your personal information will be used and disclosed for the Council’s purposes, or a directly related purpose, unless you consent to another use or disclosure, in emergencies or as otherwise required or authorised by law.

Should you wish to access or amend your personal information please make a written request to Council by: Post: PO Box 205, Hurstville BC NSW 1481 Email: mail@georgesriver.nsw.gov.au For more information, please refer to Council’s Privacy Management Plan
Should be Empty:

Exempt Tree Works - Removal of Dead, or Immediately Dangerous Trees - Private property

Details of the property owner

Location and title description of the property

Qualified arboricultural assessment