Stormwater Utility Fee Reduction Application for Nonresidential Property
Applicant Information
Name
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
-
Area Code
Phone Number
Identification
Parcel ID Number
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Owner's Name
First Name
Last Name
Use of Parcel
Parcel Information
Total Parcel Area (In acres or sq. ft.)
Total Impervious Area (In acres or sq. ft.)
Total Green Area (In acres or sq. ft.)
Adjustment Request Information
Type of Adjustment Requested
Incorrect Billing
Green Area > 20%
Green Area > 50%
Discharge Permit (Waiver)
Control Facility (BMP)*
Parking Lot Sweeping (Must provide proof of prior year sweeping)
* Maintenance agreement or storm water covenant required for BMP related fee reductions
Description of Adjustment Requested:
Upload maps, calculations, maintenance agreements, covenants, as required to substantiate the requested adjustment.
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Applicant Signature
Date
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Month
-
Day
Year
Date
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