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Town of Westborough, Massachusetts
Town of Westborough, Massachusetts
Town Seal

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Department of Public Works
Town of Westborough,
Massachusetts

STORMWATER PERMIT

Location of Property_______________________________________________________

Name of Applicant________________________________
Phone_________________
Address_________________________________________
Cell Ph._______________
Name of Owner___________________________________
Phone_________________
Address__________________________________________
Cell Ph._______________
Name of Contractor________________________________
Phone_________________
Address__________________________________________
Cell Ph._______________
Description of work to be done:
Check all that apply

 Disturb more than 5,000 SF of land

  Stockpile more than 100 CY of excavate or fill

  Disturb more than 43,560 SF of land
  Major alteration of drainage characteristics



Instructions:
  • Complete and sign this form.
  • Attach the fee and 4 copies of the plan.
  • Deliver this form, the fee, the Stormwater Management plans and narrative to the DPW.
  • The DPW will notify the Conservation Commission, Building Department and Planning Board upon submission.
The undersigned hereby requests the DPW and Conservation Commission review and consider my/our application for a Stormwater Management Permit and, by finding full conformance with the Westborough Bylaws governing said application, grant a Stormwater Management Permit to allow the activities described on this form.


Applicant’s Signature
Owner/Agent Signature


Issued By: _________________________________________ Date: ________________


Town of Westborough