Department of Public Works TELEPHONE: (508) 841-8502
Engineering Division FAX: (508) 841-8497
Stormwater Management stormwater@shrewsburyma.gov
Revised January 21, 2020
Page 1
of 2
TOWN OF SHREWSBURY
100 MAPLE AVENUE
SHREWSBURY, MASSACHUSETTS 01545-5338
STORMWATER UTILITY
PETITION FOR ADJUSTMENT
Application must be completed in full in order to be considered.
I
n the event that a property owner believes the Stormwater Utility Fee (STWF) is improperly calculated or is
otherwise incorrect, the property owner may, within 30 calendar days from the date of issuance of the Stormwater
Utility bill, and after payment of the bill in full, apply to the Shrewsbury Department of Public Works (DPW) for
an adjustmentThe DPW shall have 60 calendar days to consider the request for an adjustment and render a
written decision...
Stormwater Management Rules & Regulations, Section 12
P
roperty Owner / Business Name: _______________________________________________________________
Property Address / Condo Association: ___________________________________________________________
Mailing Address (if different): __________________________________________________________________
Phone Number: ___________________________________ E-mail: ___________________________________
Ut
ility Account Number: ___________________________ Parcel Number: _____________________________
Authorized Contact (if different from owner): ______________________________________________________
R
eason for Petition:
o Error in billing amount (e.g. incorrect tier, approved credit applied incorrectly)
o Error in impervious area (e.g. deck with pervious ground underneath, entire/portion of impervious area
on
ease
ment belongs to another)
o Identification of property owner invoiced is in error (e.g. change in ownership, closings)
o Other
Please attach a letter detailing the nature of your petition, and include any supporting documents such as photos,
or proof of easement.
I hereby request the Department of Public Works (“DPW”) to review this application and give authorization to
enter onto my property for the purposes of verifying this information. I certify that I have the authority to make such
a request and grant such authority for this property; and the information provided is true and correct to the best of
my knowledge and belief. I agree to provide updated or corrected information to the DPW should there be any
change in the information provided herein and should the DPW request more information.
Sig
nature: ________________________________________ Date: _____________________________________
Name (Please Print): ________________________________
__________________________________________
click to sign
signature
click to edit
Department of Public Works TELEPHONE: (508) 841-8502
Engineering Division FAX: (508) 841-8497
Stormwater Management stormwater@shrewsburyma.gov
Revised January 21, 2020
Page 2 of 2
This Side for Office Use Only
Petition for Adjustment Determination: Granted Denied
Impervious Area (sq.ft.) Tier Annual Rate
Current: _________________________ ____________________________________________________
Adjustment: _________________________ ____________________________________________________
New: _________________________ ____________________________________________________
If denied, reason for denial: ____________________________________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________
Signature: __________________________________________________________________________________
Name (Please Print): __________________________________________________________________________
Title: ___________________________________________ Date: _____________________________________
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