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Land and Water Resource Division (LWRD) Applications

Includes the following activities:

Note:  Do not use these applications for Consumptive Diversions and Section 401 Water Quality Certificates for Hydropower Activities. For any of the activities listed above*, complete the transmittal form listed below and one or more of the applicable forms (A through P) listed below. Review the LWRD License Application Transmittal Form for a summary of which forms must be submitted for each activity. A list of supporting documents, fact sheets and additional guidance are also referenced below in Table A. (* The Application for Exemption from Regulation in an Aquifer Protection Area does not require the submittal of the LWRD Transmittal Form.)

Land Water Resources Division (LWRD) Applications

License Name

Form Name

Instructions

Supporting Documents:
see detailed list in Table A

Additional Info

LWRD Transmittal

Application
Word, PDF
03/23/20

Instructions
09/02/20 

Instructions for Completing Attachment 40:  Structures, Dredging and Fill Fee Calculation
06/01/21

Attachments A, B, C, D 

N/A

Licenses for Activities in Aquifer Protection Areas

License Name

Form Name

Instructions

Supporting Documents:
see detailed list in Table A

Additional Info

Aquifer Protection Area Registration

Form A
Application
Word, PDF
03/23/20

Instructions
03/20/20 

Attachments 2, 12, 38, 39

 

Model Form for Developing a Materials Management Plan for Regulated Activities in Aquifer Protection Areas

Instructions for Developing a Stormwater Management Plan for Regulated Activities in Aquifer Protection Areas

Aquifer Protection Stormwater Management Plan Supplement Form

Aquifer Protection Area Permit

Form B
Application
Word, PDF
03/20/20

Instructions
03/23/20

Attachments 2, 8, 12, 20, 38, 39, 41

Model Form for Developing a Materials Management Plan for Regulated Activities in Aquifer Protection Areas

Instructions for Developing a Stormwater Management Plan for Regulated Activities in Aquifer Protection Areas

Aquifer Protection Stormwater Management Plan Supplement Form

Exemption from Regulation in an Aquifer Protection Area

This application does not require the LWRD Transmittal form.

 Application

Word PDF

12/01/20

 Instructions

12/01/20

Refer to application and instructions  Refer to application and instructions
Licenses for Activities in Tidal Waters

License Name

Form Name

Instructions

Supporting Documents
see detailed list in Table A

Additional Information

Structures, Dredging & Fill; Tidal Wetlands; Section 401 Water Quality(Tidal)

Form C
Application
Word, PDF
09/02/20

Instructions
03/23/20

Attachments 1, 3, 4, 7, 8, 9, 10, 13, 14, 18, 20, 21, 22, 23, 24, 25, 26, 41, 42 

Structures, Dredging and Fill & Tidal Wetlands

401 Water Quality

401 Pre-Filing Meeting Request Form

Certificate of Permission

Form D
Application
Word, PDF
09/02/20

Attachments 6, 8, 9, 10, 11, 14, 18, 20, 21, 22, 23, 24, 41, 42  Certificate of Permission

General Permit for Coastal Maintenance
DEEP-OLISP-GP-2015-02
Issued 10/26/2015
Effective January 1, 2016

Marina and Mooring Field Reconfiguration

Form E
Application
Word, PDF
09/02/20

Instructions
03/23/20

Attachments 6, 8, 10, 14, 20, 21, 24, 41, 42 Fact Sheet
Remedial Activities Required by Order

Form F
Application
Word, PDF
09/02/20

Attachments 6, 8, 10, 14, 20, 21, 23, 24, 33, 34, 41, 42
Residential Modification to FEMA Standards

Form G
Application
Word, PDF
09/02/20

Attachments 6, 8, 10, 14, 18, 20, 21, 35, 41, 42
Reconstruction of Permitted Structures

Form H
Application
Word, PDF
09/02/20

Attachments 6, 8, 10, 14, 18, 20, 21, 36, 37, 41, 42
General Permit for Minor Coastal Structures
DEEP-OLISP-GP-2015-01
Issued 10/26/2015
Effective January 1, 2016
4/40 Docks/Access Stairs

Form I
Application
Word, PDF
09/02/20

Instructions
03/23/20

Attachments 6, 8, 10, 14, 20, 21, 41, 42

Fact Sheet

Non-Harbor Moorings

Form J
Application
Word, PDF
09/02/20

Attachments 6, 8, 10, 14, 20, 21, 41, 42

General Permit for Dolphin Cove
GP-LIS-95-001
Issued 12/07/95

Structures, Fill, Obstructions, or Encroachments in Dolphin Cove Lagoon, Stamford

Form K
Application
Word, PDF
09/02/20

Instructions
03/23/20

Attachments 10, 14, 20, 21, 41, 42  N/A
Licenses for Activities in Non-Tidal Waters

License Name

Form Name

Instructions

Supporting Documents
see detailed list in Table A

 

Additional Information

Section 401 Water Quality Certificate (Non-tidal);

Pre-Construction Notification, USACE General Permits for CT;

Inland Wetlands and Watercourses;

Water Diversion Non-Consumptive

Form L
Application
Word, PDF
09/02/20

Instructions
03/23/20

Attachments 1, 5, 7, 8, 9, 10, 14, 15, 16, 17, 18, 19, 20, 23, 28, 30, 41, 42

401 Water Quality
401 Pre-Filing Meeting Request Form

Army Corps of Engineers Application ENG FORM 4345

Army Corps of Engineers – New England District – Regulatory/Permitting
Inland Wetlands and Watercourses
Water Diversion

For State Agency Activity or Activities Conducted on State Owned/Controlled Lands Only:

General Permit for Water Resources Construction Activities
DEEP-IWRD-GP-013)
Issued 04/02/14

Activities 1-4: Maintenance Plans

Form M
Application
Word, PDF
09/02/20

Instructions
03/23/20

Attachment 14 Water Resource Construction Activities
Activities 5-7: Infrastructure and Public Works Projects

Form N
Application
Word, PDF
09/02/20

Attachments 8, 9, 10, 14, 16, 18, 20, 23

Activity 8: Activities Authorized Under a Corps General Permit;
Activity 9: Conservation Activities

Form O
Application
Word, PDF
03/31/20

Attachments 29, 31, 32
For State Agency Activity/Activities Receiving Funding Through a State Agency:
Flood Management Certification;

Flood Management Certification with Exemption Request

Form P
Application
Word, PDF
09/02/20

Instructions
03/23/20

Attachments 8, 9, 10, 14, 18, 20, 23, 41, 42 Flood Management

Flood Management Transmittal Form for DAS-MOU

This application does not require the LWRD Transmittal form.

 Application

Word, PDF

03/19/21

 NA Refer to application
Refer to application 

 

Table A

Supporting Documents: (each application (LWRD Transmittal and Forms A-P) identifies which of the following supporting documents are required for each activity)

Attachment A:  Structures, Dredging and Fill fee calculation worksheet (if applicable)
Attachment B:  Co-applicant information sheet (if applicable) 
Attachment C:  Written permission from land owner (if applicant is not the owner)
Attachment D:  Additional signature sheet (if applicable) 

Attachment 1:   Public Notice of Application / Certification of Notice Form 
Attachment 2:   Proof of Notification / (Certified Mail)
Attachment 3:   Adjacent Parcel Notification
Attachment 4:   Application Copy to Municipality

Attachment 5:   Water Company Notification
Attachment 6:   Harbor Management Notification
Attachment 7:   Executive Summary
Attachment 8:   Conservation or Preservation Restriction Information
Attachment 9:   Remediation Documentation
Attachment 10:  Photographs showing existing conditions of the site         
Attachment 11:  Photographic Documentation of pre 1939, pre-1987 (above MHW) and/or pre-1995 installation.
Attachment 12:  Facility Boundary Map
Attachment 14:  Project Plans, use Project Plan Checklist for requirements         
Attachment 15:  Wetland Delineation Report
Attachment 16:  Water Resource Impact Table (XLSX) (PDF)
Attachment 17:  Mitigation Plan
Attachment 18:  Engineering Report Cover Sheet (Word) (PDF)
Attachment 19:  Hydraulic Summary (Word) (PDF)
Attachment 20:  Natural Diversity Database Review
Attachment 21:  DEEP Wildlife Division – Osprey Consultation
Attachment 22:  Dredging Consultation Form (Word) (PDF)
                              Reference for Coastal/Tidal Dredging
Attachment 23:  Fisheries Consultation Form
Attachment 24:  Department of Agriculture/Bureau of Aquaculture Consultation Form (Word) (PDF)
Attachment 25:  Harbor Management Commission Consultation Form (Word) (PDF)
Attachment 26:  Shellfish Commission Consultation Form (Word) (PDF)
Attachment 27:  U.S. Army Corps of Engineers (USACE) Consultation Form (Word) (PDF)
Attachment 28:  Copy of USACE Application (for PCN / 401projects)
Attachment 29:  Copy of USACE PCN Authorization Letter
Attachment 30:  Interagency Notes copy (for PCN w/DOT funding)
Attachment 31:  Copy of 401 Cert or Copy of USACE SV Submittal
Attachment 32:  Copy of FMC License
Attachment 33:  Enforcement Order Actions
Attachment 34:  Remedial Action Plan
Attachment 35:  Building Permit
Attachment 36:  Explanation of flood and erosion control structure modifications
Attachment 37:  A copy of the previous authorization, including plans
Attachment 38:  Materials Management Plan
Attachment 39:  Stormwater Management Plan  
Attachment 41:  Applicant Compliance Information
Attachment 42:  Applicant Background Information
Attachment 43:  Other Information
Attachment 44:  Coastal Consistency Review Form

 

Fact Sheets

Additional Guidance

Permits and Licenses


Content Last Updated July 7, 2021