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POLLINATOR GARDEN PERMIT APPLICATION

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  2. Date Applied for Permit

  7. Address of Proposed Pollinator Garden

  10. Example: 14-2-15-00-00-000-000

    Parcel/Property Look up

  13. Landscape plan and site plan to be uploaded to permit for review and approval. If you have more than 10 different plants - upload with site plan.

    Plant ID# for Site Plan UseHeight in InchesScientific NameCommon Name




































  15. Site Plan must be attached and shall be drawn in a scale large enough for clarity for the following: Location and dimensions of all property lines, buildings, driveway, patio and or deck, fence (including distance to property line), north directional arrow, label streets (bordering property), easements, proposed material, height in inches, and material number as indicated in this form. Example Site Plan

  17. Acknowledgment*

    No material shall be placed in a utility easement or any public street or alley right of way unless authorized by City Council.  

    A Pollinator Garden Permit approved and issued by the City of Edwardsville does not constitute compliance with subdivision covenants and restrictions.   It shall be the responsibility of the property owner or applicant to verify placement on private property and compliance with applicable subdivision covenants and restrictions.  I am responsible for compliance with my subdivision covenants and restrictions for pollinator garden restrictions and installation.   

    Any inaccurate information contained on this permit application may invalidate the permit.  The City of Edwardsville may also require me to obtain a survey of my property prior to approval of this permit.


    18. Leave This Blank:

  20. This field is not part of the form submission.