Fillable Form 8420 SSWM Rate Reduction Application (City of Bainbridge Island)

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Form 8420 SSWM Rate Reduction Application (City of Bainbridge Island)

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The Form 8420 SSWM Rate Reduction Application (City of Bainbridge Island) form is 5 pages long and contains:

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  • 23 check-boxes
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1
Public Works
Application for a Service Charge Adjustment
Rate Reduction Request (13.24.131)
Please complete the following form for stormwater service charge adjustments.
This Rate Reduction Request application is to be completed by the applicant and submitted with the in
accordance with Bainbridge Island Municipal Code 13.24.131 (See attached). Also see page 3 for service charge
adjustments /appeals and properties exempt from service charges. For any property, other than a single-family
residence:
A. Does your parcel have compacted gravel surfaces used by vehicles as a way-of-travel or
parking? ☐ Yes ☐ No
B. Is this parcel served by an engineered storm water system? ☐ Yes ☐ No
This includes low impact design (LID), stormwater management, stormwater treatment, or flow control
facilities. What percentage of impervious surface does the system treat? _____________________________
_______________________________________________________________________________________
C. Is your property a low intensity development
f
that creates or has existing impervious surfaces that cover
less than 15 percent of your parcel? ☐ Yes ☐ No
“Impervious surface” means a nonvegetated surface area which either prevents or retards the entry of water into
the soil mantle as under natural conditions prior to development and/or a hard surface area which causes water to
run off the surface in greater quantities or at an increased rate of flow from the flow present under natural
conditions prior to development. Common impervious surfaces include, but are not limited to, roof tops, walkways,
patios, driveways, parking lots or storage areas, concrete or asphalt paving, gravel roads, packed earthen materials,
and oiled macadam or other surfaces which similarly impede the natural infiltration of stormwater.
IMPERVIOUS SURFACES:
Fill in all applicable blanks below to list the square footage of all impervious areas on your parcel that is served
by the Engineered Storm Water System. The square footages need to be as accurate as possible. List large
buildings separately.
Buildings/structures
b
ft
2
Driveways
c
ft
2
Buildings/structures
b
ft
2
Sidewalks ft
2
Garages ft
2
Patios ft
2
Outbuildings ft
2
Parking ft
2
Other
d
ft
2
Please describe the surface:
Date
Parcel #
Site Address
Contact Information / Mailing Address
# ______-____-_____-_____
Application for a Service Charge Adjustment – City of Bainbridge Island – Public Works
2
a
Decks: As long as a deck allows rain water to pass through it, to be readily absorbed by the ground below, it does not
need to be included as impervious surface. As soon as the ground under the deck is covered with an impervious
material, such as plastic sheeting or concrete for example, the deck would then be counted as impervious area. The
use of a pervious ‘weed block’ type of matte would allow the deck to remain excluded from calculations. Of course, if a
roof is erected over the deck, the roof area, out to the eaves, is impervious area.
b
Buildings or structures: Include all square footage of all roofed areas, including covered porches.
c
Driveways and Parking: Include all surfaces, including: gravel, asphalt, or concrete. Indicate type and sf of each surface.
d
Other: Include sport courts, swimming pools, or any other unroofed surface that sheds water.
f
“Low intensity development” means any development, excluding single-family, which creates or has existing impervious
surfaces that cover less than 15 percent of the parcel.
SUPPORTING INFORMATION:
Attach the following to complete your application:
1. Maintenance Records
2. Engineered Drainage Report, Stormwater Schematic or Civil Plan.
The Application must be filed by November 15
th
, prior to the year in which the reduction will be applied.
Reduction shall not reduce the total fee for the property to less than 50 percent of the monthly fee calculated
for the impervious surface areas.
In order for Public Works to review the application and additional supporting information, the application must
be signed by:
● Property/parcel owner; or
● Person holding a written power of attorney from the property owner
Signature
Date
Note: Reduction in Stormwater Fees can be revoked or denied if proper stormwater facility maintenance has
not been performed and documented. See COBI Private Stormwater Maintenance Program web page at:
http://www.bainbridgewa.gov/779/Private-Stormwater-Maintenance-Program
Present this Application in Person or Mail the Application and Supporting Documents to:
City of Bainbridge Island
Attention: NPDES Permit Coordinator
280 Madison Avenue North
Bainbridge Island, WA 98110-1812
click to sign
signature
click to edit
3
Service Charge Adjustments / Appeals and Properties Exempt from Service Charges (13.24.150)
Please indicate which best characterizes how your property has been incorrectly charged:
☐ 1. The acreage of the parcel charged is in error; or
☐ 2. The parcel is nonresidential and the actual impervious ground cover of the parcel is more than 50
percent of an impervious service unit (ISU) greater than or less than the estimated or measured
impervious ground cover used in determining the charge; or
☐ 3. The service charge was otherwise not calculated in accordance with the terms of this chapter; or
☐ 4. The parcel is undeveloped.
Please indicate why your property / site is exempt from service (13.24.132)
☐ A. It is a city-owned ways-of-travel, all of which are part of the storm and surface drainage system.
☐ B. It is a private ways-of-travel which meet all the requirements below:
☐ 1. Ways-of-travel that serve two or more properties other than the tract of which it is a portion; and
☐ 2. Ways-of-travel for which an easement has been granted by recorded deed.
☐ C. State of Washington highway.
SUPPORTING INFORMATION:
Attach the following to complete your application:
1. Engineered Drainage Report, Stormwater Schematic or Civil Plan.
2. Parcel Map with noted corrections. Parcel information can be found and printed at
https://psearch.kitsapgov.com/webappa/
The Application must be filed by November 15
th
, prior to the year in which the reduction will be applied.
Reduction shall not reduce the total fee for the property to less than 50 percent of the monthly fee calculated
for the impervious surface areas.
In order to review the application and additional supporting information, the application must be signed by:
● Property/parcel owner; or
● Person holding a written power of attorney from the property owner.
Signature
Date
Present this Application in Person or Mail the Application and Supporting Documents to:
City of Bainbridge Island
Attention: Director of Finance
280 Madison Avenue North
Bainbridge Island, WA 98110-1812
Date
Parcel #
Site Address
Contact Information / Mailing Address
# ______-____-_____-_____
# ______-____-_____-_____
click to sign
signature
click to edit
4
To be Completed by City Staff
13.24.131 Rate reductions
☐ A. A parcel with compacted gravel surfaces used by vehicles as a way-of-travel or parking is eligible for a
service charge that is 75 percent of the rate for impervious surfaces set forth in BIMC 13.24.130;
B. For any property other than a single-family residence (including mobile homes, condominiums and
duplexes), if the property owner:
☐ (1) has been required by either the city or Kitsap County since January 1, 1985, to construct an on-
site stormwater management, stormwater treatment, or flow control facility as a condition of the
property’s development; or
☐ (2) has constructed voluntarily since January 1, 1985, an on-site stormwater management,
stormwater treatment, or flow control facility serving the property and exceeding city standards at
the time of construction.
☐ For parcels that construct qualifying green infrastructure (low impact development) as on-site
stormwater management, stormwater treatment, or flow control in accordance with Chapter 15.20
BIMC.
The city may, at its sole discretion, reduce the utility service fee charged by up to 50 percent for the property.
13.24.150 Service charge adjustments and appeals.
A. Any person billed for service charges under this chapter may apply for a service charge adjustment with the
director of finance no later than November 15th of the year of the bill. The applicant shall state the
specific conditions and facilities on the site which the applicant feels warrant adjustment of the service
charge as applied to the property. However, filing of such a request does not extend the period for
payment of the charge.
B. A request for service charge adjustment may be granted or approved by the director of finance only when
one of the following conditions exists:
Specific Conditions:
☐ 1. The acreage of the parcel charged is in error; or
☐ 2. The parcel is nonresidential and the actual impervious ground cover of the parcel is more than 50
percent of an impervious service unit (ISU) greater than or less than the estimated or measured
impervious ground cover used in determining the charge; or
☐ 3. The service charge was otherwise not calculated in accordance with the terms of this chapter; or
☐ 4. The parcel is undeveloped.
Describe the reason for the modification or waiver request:
Application for a Service Charge Adjustment – City of Bainbridge Island – Public Works
5
Site / Residence / Parcel or Facility
C. The property owner shall have the burden of proving that the service charge adjustment should be
granted.
D. Decisions on requests for a service charge adjustment shall be made by the director of finance based on
information submitted by the applicant and by the public works department within 30 days of the
adjustment request, except when additional information is needed. The applicant shall be notified in
writing of the director’s decision.
E. If the director of finance finds that a service charge should be adjusted, then an amended bill shall be
issued which reflects the adjusted service charge.
13.24.132 Property exempt from service charges
The following categories of property are exempt from storm and surface water utility service charges:
A. City-owned ways-of-travel, all of which are part of the storm and surface drainage system pursuant to
the city’s NPDES Phase II Municipal Stormwater Permit. This exemption does not apply to a city-owned
road that is an adjunct to a city developed property, such as NE Henshaw Place adjacent to City Hall, and
which is therefore charged a storm water fee pursuant to BIMC 13.24.130 as part of a developed
property;
B. Private ways-of-travel which meet all the requirements and have been named in accordance with BIMC
12.16.050.A, including:
1. Ways-of-travel that serve two or more properties other than the tract of which it is a portion; and
2. Ways-of-travel for which an easement has been granted by recorded deed; and
C. State of Washington highway. (Ord. 2015-20 § 2, 2015)
Describe the reason for the modification or waiver request:
Site / Residence / Parcel or Facility
Attach other documentation as needed. See COBI Stormwater Utility and/or 13.24.050 Definitions for additional
information.
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Form 8420 SSWM Rate Reduction Application (City of Bainbridge Island)

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Completed 15 July 2020

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