Public Information and Permitting Unit Pre-Application Meeting Request

* Indicates a required field

* Name:
Affiliation:
* Telephone Number:
Facsimile Number:
* Email Address:
Web Address: (if available)
Type of Project:
Confidential or Coded?:	YesNo 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:
* First Choice (mm/dd/yyyy):
* Second Choice (mm/dd/yyyy):
* Third Choice (mm/dd/yyyy):
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: timothy.drew@des.nh.gov