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Seasonal Sump Pump Discharge Permit

Before completing this form:
Please read the Seasonal Sump Pump Discharge Policy established by Resolution No. 2024-039.
If you have drainage concerns that cause your sump pump to run frequently, please review the Application for Special Consideration.

Current Sump Pump Information

Where does your sump pump discharge now? (Select all that apply)

Where does your sump pump discharge now? (Select all that apply)

A

Outside/Into my yard

B

Outside/Connection to Storm Sewer or Curb & Gutter

C

Inside my Home/Connection to Sanitary Sewer

Have you previously experienced icing of streets or sidewalks caused by sump pump discharge in the winter?

Have you previously experienced icing of streets or sidewalks caused by sump pump discharge in the winter?

Yes

No

Property Owner/Applicant Name

Property Address

Mailing Address (if different)

City, State ZIP

Best number to contact you

Email address