Stormwater Management Permit

To fill out the paper version of this form click here

Application is hereby made for review of the SWM site and related data as submitted herewith in accordance with the Springfield Township Stormwater Management Ordinance.

Plans

1. Application Type *

Simplified Plan Full Plan

New/Replacement Impervious Coverage (between 500 square feet and 999 square feet)

Square Feet

Disturbance Limit (between 5,000 square feet and 1 acre)

Square Feet *

New/Replacement Impervious Coverage (1,000+ square feet)

Square Feet *

Limit of Disturbance (1+ acre)

Acres *

2. Project Name *

Parcel Number *

Property Address/Location for Grading Permit:

Street Number

Street Name *

City *

State *

Zip Code *

3. Applicant Name *

Telephone Number *

Applicant Email Address *

Fax Number

Applicant Address

Street Number

Street Name *

City *

State *

Zip Code *

Applicant is: *

Property Owner Contractor

4. Property Owner Name *

Telephone Number *

Owner Address

Street Number

Street Name *

City *

State *

Zip Code *

5. Registered Engineer Name *

6. Contractor Name *

Project Information

1. Total Area (Acres or square feet) *

Disturbed Area (in SqFt) *

2. Purpose or Intent of Land Disturbance *

Proposed Work and Materials Used *

3. Other Properties

Does work back up or discharge water on or affect any other property in any way?

Yes No

Note property address and to what extent. *

4. Schedule of Work

Start Date *

Completion Date *

Permit Terms and Conditions

1. I agree that I will comply with all Ordinances, laws and Township policies regulating grading, land disturbance, erosion/sedimentation control, and storm water management.

2. I agree to allow access to said activities for inspection by Township of Springfield Code Officer and Engineer.

3. All erosion/sedimentation control measures will be installed before land disturbance activities begin and be properly maintained throughout the grading/land disturbing activities. I further agree to add any additional erosion/sedimentation control measures as requested by Springfield Township.

4. I agree that I will be responsible for any damage to any utilities, public right-of-way and city streets caused by this work.

5. PERMIT FEE ($450) COVERS ONE (1) HOUR ENGINEER REVIEW TIME, ONE(l) SITE VISIT BY CODE OFFICER AND ADMINISTRATIVE COSTS. I AGREE TO PAY FOR ADDITIONAL ENGINEERING REVIEW FEES AND SITE VISITS AS REQUIRED.

Signature of Applicant or Responsible Party

Date *

Payment of fees for this application will be requested via email once your submission has been reviewed.  Please verify that emails from donotreply@springfielddel.co are not sent to your spam/junk mail folder.  The email will contain a link to this form allowing you to make a secure payment by credit card.  The amount shown below is an estimated amount and may be adjusted once your submission is reviewed.

Payment Amount Due

Stormwater Management Permit

Plans

Project Information

Permit Terms and Conditions

Powered by Versiform

Map Spreadsheet Columns to Import