TREE CUTTING PERMIT NO.

This Permit is hereby issued to:

(name of owner - individual or company - the Permittee)

for tree cutting on

(insert legal description)

(insert municipal address)

pursuant to the provisions of the Corporation of the City of Port Coquitlam, Bylaw 2836, subject
to:

1. Tree cutting being undertaken strictly in accordance with the terms and conditions of this
permit and any plans and specifications being attached hereto as part of this permit.

The Permittee depositing the required security and giving permission to the Director of
Parks and Recreation or designated staff to enter the subject properties when necessary.

Any other conditions stipulated hereunder:

THIS PERMIT EXPIRES ON

Director of Parks and Recreation

Dated this