Category 1A Inland Self-Certification Form - (also - U S Army - nae usace army 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering your Permittee Name & Address, along with your Phone number & Email address. This information is crucial for identification and communication.
3. Fill in the Work Location/Address and provide Latitude/Longitude coordinates to pinpoint the project site accurately.
4. Specify the Waterway name where the work will take place, followed by Contractor Name & Address, including their Phone number & Email address.
5. Indicate Proposed Work Dates by filling in both Start and Finish dates to outline your project timeline.
6. Check all applicable categories under which the work will be done within Inland Waters & Wetlands, referring to Appendix 1 for guidance.
7. Provide details on Wetland impact and Waterway impact by entering square footage and linear feet as required.
8. Write a Brief Project Description that clearly outlines the purpose of your project.
9. Answer whether your project includes any secondary impacts, providing a description if applicable.
10. Finally, sign and date the form as the permittee to confirm your agreement with the terms outlined in Category 1 of this Connecticut General Permit.

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