Applications and Forms

Dam Safety

• Dam Order Application Form (pdf)
• Dam Order Application Form (MS-Word)

On-Site Loan Program

• Pre-Qualification Application - Use this version if you want to print the application and complete as a paper copy.
• Pre-Qualification Application - Use this version if you want to complete the application electronically, then print and sign.
• Reimbursement Request Form- Use this version if you want to print the application and complete as a paper copy.
• Reimbursement Request Form- Use this version if you want to complete the application electronically, then print and sign.

Engineering Planning Advance Program

• Engineering Planning Advance Application Form

Clean Water State Revolving Fund and Pollution Control Grants & Drinking Water State Revolving Fund

Loan and Financial Related Forms

• DWSRF FFY22 PList Application Form - due 2/28/2022 to anr.dwsrfplist@vermont.gov
• CWSRF FFY22/SFY23 PList Application Form - due 2/28/2022 to anr.cwsrfplist@vermont.gov
• DEC/RD Certification Form
• FUNDING APPLICATION - Funding Application for use in all Water Infrastructure Financing Programs grants and loans. YOU MUST RIGHT CLICK, 'SAVE LINK AS', and save remotely before completing.  Note: VT SRF application submission is now online!
  Visit ANR Online to get started.
• Disbursement Request Form and Instructions
• Change in Authorized Representative or Add an Additional Authorized Representative form
• RFQ Certification Form
• Template Municipal Letter of Support for Private Project
• Cost and Effectiveness Certification Form
• Fiscal Sustainability Plan Certification Form

Planning

• Preliminary Engineering Report Format pdf
• Prelmininary Engineering Report Format MSWord

Environmental Review

• Environmental Information Document - Environmental Report Form DWSRF & CWSRF

Construction

• Request for Reduction in Retainage Form
• Partial Payment Estimate Form
• Attorney Title Easement Certficiation Form
• Change Order Form

Disadvantage Business Enterprise

• DBE Reporting Form 5700-52A
• DBE Subcontractor Participation Form 6100-2
• DBE Subcontractor Performance Form 6100-3
• DBE Subcontractor Utilization Form 6100-4

Davis-Bacon

• SF-1444 Request for Authorization of Additional Classification and Rate
• WH-347 Weekly Payroll Report and Certification
• SF-1445 Wage Interview
• EEO Labor Poster (September 2015)
• WH 1321 Davis-Bacon Wage Poster

American Iron and Steel

• EPA March 20, 2014 Memo Guidance Document
• Audit Checklist (Coming Soon)