New Submission

Please note: fields marked with a red asterisk * below are required. You will not be able to submit the form until all mandatory questions are answered.
Project Name:*field type single line
Input blocked. Maximum character limit of 4000 characters reached.
Is this a transportation project?*field type radio button
Is this a transportation project?YesNo
Is this request for a mitigation site?*field type radio button
Is this request for a mitigation site?YesNo
What type of request is this?*field type checkbox
What type of request is this?BufferIP Stream DeterminationIsolated WetlandStream
Check all that apply.

Owner Information
×
- Name on the Recorded Deed:*field type single line
  Input blocked. Maximum character limit of 4000 characters reached.
- Responsible Party :field type single line
  (for LLC, Corporations, businness, agency, etc.)
  Input blocked. Maximum character limit of 4000 characters reached.
- Telephone Number:field type single line
  Input blocked. Maximum character limit of 4000 characters reached.
- Email Address:*field type email
- How would you like to received your determination?*field type checkbox
  How would you like to received your determination?USPSEmail
- Mailing Address:*field type address
  Street Address
  Address Line 2
  City
  State / Province / Region
  Postal / Zip Code
  Country
Add additional owner
Is there an agent or consultant responsible for the request?*field type radio button
Is there an agent or consultant responsible for the request?YesNo
Attach agent authorization letter:*field type file upload
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PDF only

Project Information

Has anyone form DWR done a previous site visit?*field type radio button
Has anyone form DWR done a previous site visit?YesNoOther
Staff Name:field type single line
Input blocked. Maximum character limit of 4000 characters reached.
Date of Visit:field type date

Nearest Highway/Street:*field type single line
Input blocked. Maximum character limit of 4000 characters reached.
Nearest Town:*field type single line
Input blocked. Maximum character limit of 4000 characters reached.
Nearest Named Stream:*field type single line
Input blocked. Maximum character limit of 4000 characters reached.
River Basin:*field type drop-down

	County:*field type drop-down
Row 1×	County:*field type drop-down	×

Please attach a map of the site indicating project boundaries on the USGS 1:24,000 Topo.field type file upload
Click the upload button or drag and drop files here to attach document
Drop files here
You have reached the maximum file limit: .
Pdf file type only
TOPO map look up: https://experience.arcgis.com/experience/a16078049de54d42a2bc384b9ceda91f
Please attach a map of the site indicating project boundaries on the NRCS Soil Survey.field type file upload
Click the upload button or drag and drop files here to attach document
Drop files here
You have reached the maximum file limit: .
Pdf file type only
Soil Survey Link: https://experience.arcgis.com/experience/a16078049de54d42a2bc384b9ceda91f

Please provide the Latitude and Longitude for physical location for the determination that. If you have a physical address you can look up the Latitude and Longitude by typing in an address or filling out the information manually.
Choose below how you would like to provide this information.field type radio button
Choose below how you would like to provide this information.Address LookupManually
Project Look Up Address:field type address
Street Address
Address Line 2
City
State / Province / Region
Postal / Zip Code
Country
Latitude:field type single line
Input blocked. Maximum character limit of 4000 characters reached.
Longitude:field type single line
Input blocked. Maximum character limit of 4000 characters reached.
Misc attachments:field type file upload
Drop files here
You have reached the maximum file limit: .
pdf or kmz file types only