Form Center

By signing in or creating an account, some fields will auto-populate with your information and your submitted forms will be saved and accessible to you.

Application To Place Fill

  1. mm/dd/yyyy

  2. Wetlands within 100 feet?*

  3. Is the property in the 100-year floodplain?*

  4. If no, is it subject to substantial flooding*

  5. Will the placement of fill cause increased stormwater runoff or other flooding impacts on abutting properties?*

  6. A plan must be submitted along with this application showing the area of proposed fill.

  7. I, the undersigned have read, understand and agree to abide by the Board of Health regulation regarding the placing of fill. I understand that I am responsible for demonstrating that the placement of fill does not cause increased stormwater runoff or other flooding impaces on abutting properties. I may be required to hire an engineer to certify that there are no adverse impacts.

  8. I understand that it is my obligation to contact the Conservation Commission (781-721-7152), Engineering Department (781-721-7120) and the DPW Commissioner (781-721-7100). Applicant assumes full responsibility for the final grading of the fill and for it's impact, including but not limited to any adverse effects on adjacent property.

  9. Please type in your full name. This will be considered an electronic signature.

  10. Applicant must obtain signatures from the following departments. Departments below are only signing as to their respective authority:

  11. PAYMENT OPTIONS

    Payment must be made before application will be processed. Click the link below for online payment, or mail $50 check payable to "Town of Winchester," to Health Dept., 71 Mt. Vernon St, Winchester MA 01890.

  12. Leave This Blank:

  13. This field is not part of the form submission.