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 Pre-Application Questionnaire		07/01/2024
Request to Change Company/Individual Name	Word Request to Change Company/Individual Name, PDF Request to Change Company/Individual Name	N/A	03/08/22
Request to Change Company/Individual Information	Word Request to Change Company/Individual Information, PDF Request to Change Company/Individual Information	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 Applicant Background Information, PDF Applicant Background Information	PDF Applicant Background Information Instructions	06/15/17
Applicant Compliance Information	Word Applicant Compliance Information, PDF Applicant Compliance Information	PDF Applicant Compliance Information Instructions	Word 08/21/25; PDF 08/08/11
Certification of Notice - Notice of Application	Word Certification of Notice - Notice of Application, PDF Certification of Notice - Notice of Application	PDF Certification of Notice Instructions	01/09/2026
Coastal Consistency Review Reference Guide to Coastal Policies and Definitions Connecticut Coastal Management Manual	PDF Coastal Consistency Review 07/03/2024	PDF Coastal Consistency Review Instructions (03-2022) pending updates
Request for Natural Diversity Data Base (NDDB) State Listed Species Review	DEEP's ezFile Portal
Latitude and Longitude	Word Latitude and Longitude, PDF Latitude and Longitude	N/A	08/08/11
Checklist for Solid Waste Disposal Areas (Including Leachate Parameters)	Word Checklist for Solid Waste Disposal Areas, PDF Checklist for Solid Waste Disposal Areas	N/A	8/17/11
Written Authorization Form RCSA Section 22a-174-2a(a)	Word Written Authorization Form RCSA Section 22a-174-2a(a), PDF Written Authorization Form RCSA Section 22a-174-2a(a)	PDF Written Authorization Form Instructions	10/19/23
The form above 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.
License Transfer	Word License Transfer	PDF License Transfer Instructions	09/10/25
Confirmation of Closing-Before License Transfer Approval-Attachment C	Word Confirmation of Closing-Before License Transfer Approval-Attachment C, PDF Confirmation of Closing-Before License Transfer Approval-Attachment C	N/A	08/21/25
Confirmation of Closing-After License Transfer Approval	Word Confirmation of Closing-After License Transfer Approval, PDF Confirmation of Closing-After License Transfer Approval	N/A	08/01/25

Permits and Licenses

Content Last Updated July 2026

Common Forms

Common Forms

Name

Forms

Instructions

Last Revised