Thurston County Resource Stewardship Storm and Surface Water Utility Stormwater Fee Credit Program STORMWATER FEE CREDIT PROGRAM APPLICATION APPLICANT INFORMATION Applicant Name: Business Name: Phone: Fax: State: ZIP Code: Email: Other: Property Address: Mailing Address: City: Owner / Property Manager (Please circle) PROPERTY INFORMATION Multi-Family School Commercial Industrial Church Parking Lot Mixed Use (Please circle) Tax Parcel Number(s): Property Area: _____________Acres NPDES Regulated area: Yes / No Impervious Area: ____________sq ft SUPPORTING DOCUMENTS The documents listed below are required to qualify for the Fee Credit Program AGREEMENT TO MAINTAIN STORMWATER FACILITIES AND TO IMPLEMENT A POLLUTION SOURCE CONTROL PLAN Templates can be found at http://www.co.thurston.wa.us/stormwater/manual/manual-home.html AFN: SPILL PLAN (required for businesses identified by the county) On file: Annual maintenance and inspection report submitted Certification and Signature (must be signed by owner or authorized official) I certify under penalty of law that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure qualified personnel properly gather and evaluate the information submitted. Based on my inquiry or the person or persons who manage the site or those persons directly responsible for gathering the information, the information submitted to the best of my knowledge and belief true, accurate and complete. Printed Name: Title: Signature of applicant: Date: Page 1 of 2 Document1 EDUCATIONAL SERVICES CREDIT – SCHOOLS ONLY – Stormwater Curriculum Credit – 40 % Watershed Partners Credit – 10% Stormwater Curriculum Credit - Schools that provide, as part of their official curriculum, instruction on water quality monitoring, nonpoint pollution prevention, groundwater aquifer protection and other topics related to water resources protection are eligible for a 40% reduction in their stormwater fee. Watershed Partners Credit - All schools that support existing watershed-based environmental education programs and provide instruction on water quality including water quality monitoring, nonpoint pollution prevention, groundwater aquifer protection and other topics related to water resources protection are eligible for an additional 10% reduction in their stormwater fee. Do not write in the shaded area (County Use Only) CHRIS MAUN, EDUCATION AND OUTREACH SPECIALIST II Date: Signature: COMMERCIAL BUISNESS FEE CREDIT Annual Facility Maintenance and Reporting Credit (25%) - To be eligible for the Commercial Business Fee Credit, applicants must have a recorded Commercial Stormwater Agreement to Maintain with Thurston County. This agreement commits the property owner to maintain facilities and implement a Pollution Source Control Program. In addition, owners identified by Thurston County will be required to develop and submit a Spill Plan in accordance with the Thurston County Business Pollution Prevention Program. Third Party Certification Credit (50%) - This credit is available to parcel owners who can provide documentation for at least one of the following certifications: Approved Conservation Plan- Thurston County Conservation District Salmon-Safe Certification - Salmon-Safe, Inc. Sustainable Forestry - Forest Stewardship Council Green Building Certification - Built Green Washington, Built SMART, Earth Advantage, LEED and others Other third party certifying agencies or products that meet the intent of this credit may be considered by the Thurston County Stormwater Utility staff upon parcel owner request. Stormwater Best Management Practices Credit (5, 10, and 25%) - This credit is available to existing developed parcel owners that implement additional Best Management Practices on their parcel. There are three levels of credit available: 5% credit to parcel owners that implement one or more of the BMPs listed below with or without documentation that a stormwater benefit will be achieved. 10% credit to parcel owners that implement rainwater harvesting as provided for in the Thurston County Code section 15.06.040. 25% credit to parcel owners that implement a BMP or series of BMPs with documentation that verifies that a water quality benefit will be achieved consistent with the current Drainage Design and Erosion Control manual. BMP credits can be combined with any of the other fee credits for up to a maximum total of 50% fee credit. SIGNATURES Do not write in the shaded area (County Use Only) RYAN LANGAN, STORMWATER OPERATIONS & MAINTENANCE SUPERVISOR Date: Signature: Do not write in the shaded area (County Use Only) Larry Schaffner, NPDES COMPLIANCE / PLANNING COORDINATOR Date: Signature: Page 2 of 2 Document1