Engineering Services | 925 S Main Street, Lebanon, Oregon 97355 | 541.258.4906 | cdc@ci.lebanon.or.us
APPLICANT INFORMATION
Name (Owner): Phone:
Address: Email:
Company Name:
ENGINEERING INFORMATION
Engineering Firm: Phone:
Address: Email:
Designated Contact Person:
Location of Work:
Description of Work:
SUBMITTAL REQUIREMENTS
Five (5) copies of an engineered site plan including: Please provide the following information:
Paving
Total existing impervious surface
Drainage
Total new impervious surface
Water
New water meters and sizes
Sewer
“Irrigation Only” meter size
Landscaping (can be a separate plan)
ADDITIONAL INFORMATION REVIEW FEES
All review comments must be incorporated into the
plan and the reproducible plan stamped “APPROVED
FOR CONSTRUCTION” prior to beginning
construction.
Fixed Fee of $500.00 $
Total acres: _____ x $350.00 $
Total Fee: $
AGREEMENT – The undersigned applicant agrees to comply with all city ordinances
Applicant: Signature:
OFFICE USE ONLY
Date Received: Received By: Receipt No.:
APPLICATIONFORSITE
PLANREVIEW
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signature
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