Common Forms

Emergency Burn Ban In Effect 10/26/24 - An emergency burn ban is now in effect for all Connecticut State Parks, Forests, and Wildlife Management areas, prohibiting the use of all outdoor grills, firepits, and campfires, and the kindling and use of flame outdoors. DEEP and local agencies are working to contain several active fires across the state. Please avoid all affected State Parks and Forests, as well as the blue-blazed Mattabesett Trail. The Enduro Trail in Voluntown and portions of North Stonington within the Pachaug State Forest are closed at this time. Rocky Neck State Park is also closed until further notice due to a brush fire. Please note that today's forest fire danger report remains at a 'very high' or 'extreme' level. More information about the current fire danger, burn ban and recommended safety measures can be found here

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 the Office of Innovative Partnerships and Planning (IPP) at DEEP.OPPD@ct.gov.

Name	Forms	Instructions	Last Revised
Pre-Application Questionnaire	PDF		07/01/2024
Request to Change Company/Individual Name	Word, PDF	N/A	03/08/22
Request to Change Company/Individual Information	Word, PDF	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	PDF	06/15/17
Applicant Compliance Information	PDF	PDF	08/08/11
Certification of Notice - Notice of Application	Word, PDF	PDF	03/20/20 (instructions)
Coastal Consistency Review Reference Guide to Coastal Policies and Definitions Connecticut Coastal Management Manual	PDF 07/03/2024	PDF (03-2022) pending updates
Request for Natural Diversity Data Base (NDDB) State Listed Species Review	PDF 12/7/22	PDF 3/20/20
Latitude and Longitude	Word, PDF	N/A	08/08/11
Checklist for Solid Waste Disposal Areas (Including Leachate Parameters)	Word, PDF	N/A	8/17/11
Written Authorization Form RCSA Section 22a-174-2a(a) This form is to be completed by any municipality or corporation that is required to obtain approval of a duly authorized representative from the commissioner in accordance with RCSA sections 22a-174-2a(a)(1)(D) or 22a-174-2a(a)(2)(B). All other entities are not required to complete this form.For those affected entities, this form must be submitted and approved prior to submitting any affected air bureau documents.	Word, PDF	PDF	10/19/23
License Transfer	Word	PDF	03/24/20
Confirmation of Closing-After License Transfer Approval	Word, PDF	N/A	8/31/12

Permits and Licenses

Content Last Updated July 3, 2024

Connecticut Department of Energy & Environmental Protection

Common Forms

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Forms

Instructions

Last Revised