Landscape Site Inspection (LSI)

• Address

• DA number

• Conducted on

  Date

• Prepared by

INSPECTION OFFICER DETAILS

• Assessment Officer

  Renate Bill

  George Elrick

• Signing Officer

  Select Nathan McBriarty Phil Thompson Bernie Boland Ron Brear Joel Harris Luke Preston Bryce Short

  • Nathan McBriarty
  • Phil Thompson
  • Bernie Boland
  • Ron Brear
  • Joel Harris
  • Luke Preston
  • Bryce Short

SITE INSPECTION DETAILS

• Address

• Inspection date

  Date

• Street Tree

• Number of trees

  Select 1 2 3 4 5 6 7 8 9 10 11 12 13

  • 1
  • 2
  • 3
  • 4
  • 5
  • 6
  • 7
  • 8
  • 9
  • 10
  • 11
  • 12
  • 13

• Species

• Height

• Maturity/age

• Condition

• Arborist report required?

  Yes

  No

  N/A

• Edging?

  Yes

  No

  N/A

• Mulching?

  Yes

  No

  N/A

• Existing Site Trees/Vegetation

• Trees to be retained/removed

• Number of trees

  Select 1 2 3 4 5 6 7 8 9 10 11 12 13

  • 1
  • 2
  • 3
  • 4
  • 5
  • 6
  • 7
  • 8
  • 9
  • 10
  • 11
  • 12
  • 13

• Species

• Height

• Maturity/age

• Condition

• Arborist report required?

  Yes

  No

  N/A

• Existing Trees on adjacent properties

• Number of trees

  Select 1 2 3 4 5 6 7 8 9 10 11 12 13

  • 1
  • 2
  • 3
  • 4
  • 5
  • 6
  • 7
  • 8
  • 9
  • 10
  • 11
  • 12
  • 13

• Species

• Height

• Maturity/age

• Condition

• Arborist report required?

  Yes

  No

• Impact by development

  Yes

  No

  N/A

MISCELLANEOUS SITE DETAILS

• Site Photos

  Media

• Other street species used within the street?

• Powerlines

  Select Overhead Underground

  • Overhead
  • Underground

• Any impact on site services?

  Yes

  No

• Any impact on street lights?

  Yes

  No

• Any impact on Culverts/Drainage Pits

  Yes

  No

• Any impact on proposed driveway location?

  Yes

  No

Signature

• Add signature

  Sign