.13 Property Owner Notification of Tree Removal (M-689) SAMPLE.pdf
PDF 269 KB Posted
- Attached to
- Tree Trimming & Stump Removal Services
- Solicitation number
- 6100065367
- Issued by
- Fulton County, Pennsylvania
About this file
This is a Property Owner Notification form (M-689) issued by the Pennsylvania Department of Transportation (PennDOT) to inform abutting property owners of tree removal work scheduled within PennDOT's Right-of-Way. The form serves as notification that tree trimming and stump removal services will be performed by a designated contractor and requests property owner preferences regarding resulting materials. The notification form collects essential property information including owner name, county, address, state route, segment location, and telephone number. Property owners are asked three questions regarding their preferences: whether they want the resulting wood from tree removal, whether they want a load of wood chips if available, and whether wood chips may be blown onto their property. The property owner's signature on the form indicates receipt of notification but does not imply agreement or disagreement with the work being performed.
The form is distributed in triplicate with copies designated for PennDOT, the contact person, and the property owner. Property owners requiring additional information are directed to contact the appropriate PennDOT District Roadside Unit, with contact numbers provided for all 11 operational districts across Pennsylvania. The form specifies that waste materials including chips, mulch, leaves, and branches are primarily hauled away and disposed of, with fly chipping available upon request with specific project instructions. This notification form is part of PennDOT's broader tree trimming and stump removal services contract in Greene County, which is designated as a Small Business Procurement with eligibility limited to DGS-certified small businesses, with bids required to be submitted electronically through the PA Supplier Portal.
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Text version
This notification is to inform you, the abutting property owner, of the tree work that will take place within the PennDOT
Right-of-Way. If you should require additional information, please contact the PennDOT Roadside Unit indicated at the bottom of this form.
This work will be performed by Contractor: _______________________________________________________ .
Property Information:
Owner Name:_ ______________________________________________ County:________________________
Address:_ __________________________________________________ State Route:_ ___________________
__________________________________________________________ Segment:_____________ Left or Right
Telephone:__________________________________________________
1. Do you want the resulting wood?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . o Yes o NO
2. Do you want a load of wood chips if any are available?. . . . . . . . . . . . . . . . . . . . . . . . . o Yes o NO
3. May the resulting wood chips be blown on your property?. . . . . . . . . . . . . . . . . . . . . . . o Yes o NO
* Property Owner Signature:_________________________________________ Date:_______________
Contact Person:_ _________________________________________________ Date:_______________
* The property owner's signature does not imply that he or she agrees or disagrees with the work being performed.
PennDOT District Roadside Units
WHITE - PennDOT YELLOW - Contact Person PINK - Property Owner
M-689 (8-08) Sample
ProPerty owner notification of tree removal PleaSe tyPe or Print in blue or black ink all information o District 1-0 • (814) 678-7147 o District 2-0 • (814) 205-1192 o District 3-0 • (570) 368-4224 o District 4-0 • (570) 963-4048 o District 5-0 • (610) 871-4139 o District 6-0 • (610) 205-6753 o District 8-0 • (717) 787-7600 o District 9-0 • (814) 696-7226 o District 10-0 • (724) 357-2833 o District 11-0 • (412) 429-4954 o District 12-0 • (724) 439-7374
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