Wetlands Disturbance Permit Application Form
Applicant Name
Organization/Company (if applicable)
Phone
Email
Address
Project Title
Project Location
Parcel Number(s)
Proposed Start Date
Description of Proposed Activity
Type of Wetland (if known)
Approximate Area of Wetland Affected (sq. ft. or acres)
Purpose and Need for the Project
Alternatives Considered to Avoid/Minimize Impacts
Supplemental Information / Attachments (maps, plans, reports)