1. (a) To apply for a PBN, the applicant shall submit:

   1. (1) A complete “Alteration of Terrain Permit by Notification Application Addendum” form, NHDES-W-01-002, dated January 2026, available at https://onlineforms.nh.gov?formtag=nhdes-w-01-002;
   2. (2) The information required pursuant to Env-Wq 1503.05;
   3. (3) The information in (1) and (2), above, as PDF files with text that is searchable through optical character recognition (OCR) to aot@des.nh.gov with the project name and location by street address, town or city, and the tax map, lot, block number; and
   4. (4) The application fee required pursuant to RSA 485-A:17, II(a).

2. (b) By signing the form in (a)(1), above, the applicant and a qualified engineer attest that:

   1. (1) They have reviewed Env-Wq 1512.03, and the project meets the eligibility requirements in Env-Wq 1512.03;
   2. (2) The information requested in Env-Wq 1512.04 is submitted with this application;
   3. (3) Work has not started for which a permit is required but was not obtained;
   4. (4) Temporary water quality protection measures in accordance with Env-Wq 1505.05 that are adequate to prevent violations of the surface water quality (SWQ) standards will be used during the construction phase of the proposed activity and maintained until all areas are stabilized;
   5. (5) The permanent methods for protecting water quality proposed in the application meet the requirements of Env-Wq 1507.02 and are adequate to prevent violations of the SWQ standards;
   6. (6) Changes in runoff hydrology, determined in accordance with Env-Wq 1504.09, will be within the limits allowed by Env-Wq 1507.05 and Env-Wq 1507.06;
   7. (7) Cold weather site stabilization measures, as specified in Env-Wq 1505.06, will be implemented as part of the project if applicable;
   8. (8) The project does not use naturally-occurring wetlands to treat or detain stormwater runoff from the proposed development, unless a permit that specifically allows the impacts has been issued pursuant to RSA 482-A;
   9. (9) Pursuant to RSA 485-A:17, II-b(g), there are no pending enforcement actions under RSA 482-A, RSA 483-B, RSA 485-A:17, or RSA 485-A:29-44 or of any rule adopted or permit or approval issued pursuant to RSA 482-A, RSA 483-B, RSA 485-A:17, or RSA 485-A:29-44 on the property for which the project is proposed;
   10. (10) The project meets the requirements and intent of RSA 430:51-57 and Agr 3800 relative to invasive species;
   11. (11) For projects requiring an ecological review in accordance with Env-Wq 1503.08(a), the project has incorporated into the project design all final conservation measures recommended by the ecological review section of the department to assure the project does not appreciably jeopardize the continued existence of threatened and endangered species as defined in Fis 1002.04, if applicable;
   12. (12) The applicant has the legal right to undertake the project on the property; and
   13. (13) No reason specified in Env-C 209 exists for denying the permit.

Source. #14472, eff 1-19-26, EXPIRES: 1-19-36