New Hampshire Department of Environmental Services - Public Information Center Pre-Application Meeting Request Form

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Pre-Application Meeting Request

Suggested Meeting Preparation: http://des.nh.gov/PermitGuide

Name:
Affiliation:
Telephone Number:
Facsimile Number:
Email Address:
Web Address (if available)

Type of Project:
Confidential or Coded?:	Yes No Select 'Yes' if you wish to assign a symbolic “code” name for a project at the time of the pre-application meeting to maintain its confidentiality due to such factors as timing, trade secrets, or other proprietary reasons.
Location(s):
Description:
Likely Environmental Impacts:
Duration:
Critical Deadlines:
Desired Date for Pre-Application Meeting Date/Time Options:
Desired Date for Pre-Application Meeting Date/Time Options:
First Choice:
Second Choice:
Third Choice:
Who Will Accompany You?
Do you want other federal, state, local, or private representatives to attend the meeting?
Other Request-Related Information?

Submit questions to: pip@des.state.nh.us