Download Mosquito/Fly Permit Application Form

1. Fill in all information regarding the person or organization requesting treatment. Make sure to fill in the customer's name who should be contacted if there are any questions. Fill in this information even if the customer and applicator, as specified in item #2, are the same.

2. Fill in all applicator and organization or applicator business information. The applicator must be certified in either Category 8B (mosquito) or 8C (campground). The applicator and/or the applicator business must be licenses for the current license year.

3. Check which type of application applies to your proposed treatment.

4. Fill in the County and Municipality in which the treatment will be performed.

5. Fill in the areas to be treated. Be specific here, for example: campground areas, golf course hole numbers, bodies of water, etc. If you intend to apply a larvicide to a body of water follow the label directions carefully. The program may request additional information or clarification.

6. Fill in the target pests you intend to treat.

7. Check the method you will use to determine when to treat. For example: coordinate with your County Mosquito Control Agency, hire a professional consultant, spray according to citizen complaints, etc.

8. Enter the information concerning the pesticide(s) you propose to use. Enter product name(s) and EPA registration number(s). Fill in the dilution rate you intend to use. Leave this blank if this is a ULV application. Enter the calibrated application rate you will use. Fill in the method of application you propose, for example: ULV, thermal fog, mist blower, hand scatter, aerial, etc. If you want to make a change in your treatment program after you have received an approved permit, call the Pesticide Control Program for a revised permit.

9. Attach a copy of a map which indicates the area to be treated. Mark on this map the specific area(s) of treatment you filled in under item #5 of the permit. Permit applications will be returned if the map is unclear, incomplete or missing.

Note: The applicator must then sign his name stating that he agrees to follow all the most current label directions for the pesticide(s) to be used; will be responsible for all damages which may occur from the proposed treatment; will abide by any conditions placed on the permit upon approval; and will submit the required records of application to the county mosquito control agency and the Pesticide Control Program within 3 weeks of the application.

If the proposed treatment is for fly control, send your application directly to the Pesticide Control Program (see address below.)

If the proposed treatment is for mosquito control, contact your County Mosquito Control Agency to arrange to have your equipment inspected and to discuss your proposed control program. Your equipment should be properly maintained and calibrated beforehand, so that you can actually demonstrate it to the county. Bring this permit application with you to your county mosquito control agency. They need to sign-off on it. The county mosquito control agency will send the application to the Pesticide Control Program for our review. If your county mosquito control agency will not cooperate in this program, contact the Pesticide Control Program at (609) 984-6666 for alternate instructions.

Instructions for County Mosquito Control Agency:

10. Fill in the make, model and serial number of each sprayer you check. If you need more room please attach an additional page to the application.

11. Check whether the equipment is properly maintained and calibrated. If you have checked a ULV sprayer, fill in the mass median diameter (MMD) of the spray droplets in the space provided. If there are any irregularities or the machine is not in running condition when you inspect it, please note this.

12. Check whether or not you recommend the proposed mosquito/fly larviciding/adulticiding program.

13. Explain the reason for your recommendation or objection to this spray program. Your technical assistance and professional evaluation of this proposed spray program serves as valuable information in the permit process. If the county is already providing mosquito control in the proposed treatment area, we must be informed.

Note: Sign and date the permit application upon completion of your review.

Please mail the completed application, including the required Mosquito Agency sign-off and sketch of proposed treatment area, to:

NJ Department of Environmental Protection Pesticide Control Program - MC 401-04A Attn: Mosquito/Fly Permits PO Box 420 Trenton, NJ 08625

Applications for mosquito or fly control are also reviewed by the State Office of Mosquito Control Coordination. The issuing authority for all permits, however, is the Pesticide Control Program. Call 609-984-6568 with any questions.

Review time varies but you should allow at least 3 weeks for the permit to be returned to you. There is no fee for the permit this year.