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Common Forms

Certain Common Forms are typically required to be submitted regardless of the type of permit you are seeking. For example, the Applicant Compliance Information Form may be submitted with some applications, including general permit registrations. If you have any questions regarding which forms must be submitted, please review the appropriate program fact sheet in the User's Guide to Environmental Permits, or contact our Permit Assistance Office at 860-424-3003.

Name
Forms
Instructions
Last Revised

Request to Change Company/Individual Name

Word, PDF
4 Pages

N/A

03/23/20

Request to Change Company/Individual Information

Word, PDF
4 Pages

N/A

02/26/13

Applicant Background Information

Note: Do not use this form for solid waste facilities; use the form:
Background Information (DEEP-SW-APP-101)

Word, PDF
5 Pages

PDF
1 Page

06/15/17

Applicant Compliance Information

Word, PDF
2 Pages

PDF
1 Page

08/08/11

Certification of Notice - Notice of Application

Word, PDF
1 Page

PDF
1 Page

03/20/20
(instructions)

Coastal Consistency Review

Reference Guide to Coastal Policies and Definitions
Connecticut Coastal Management Manual

Word, PDF
5 Pages

PDF
4 Pages

3/20/20

Request for Natural Diversity Data Base (NDDB) State Listed Species Review

Word, PDF
6 Pages

PDF
11 Pages

03/20/20

Latitude and Longitude

Word, PDF
1 Page

N/A

08/08/11

Checklist for Solid Waste Disposal Areas
(Including Leachate Parameters)

Word, PDF
25 Pages

N/A

8/17/11

Written Authorization Form RCSA Section 22a-174-2a(a)(2)(B)

Only Title V corporations identified in RCSA Section 174-2a(a)(2)(B) must complete and submit the Written Authorization Form. For those entities, this form must be submitted and approved prior to submitting any Title V documents as required by RCSA Section 22a-174-33.

Word, PDF
3 Pages

PDF
4 Pages

05/21/19

License Transfer

Word, PDF
9 Pages

PDF
10 Pages

03/24/20

Confirmation of Closing-After License Transfer Approval

Word, PDF
1 Page

N/A

8/31/12

Permits and Licenses


Content Last Updated March 24, 2020.