Department of Public Works
Civil Improvement Plans
Submittal Application and Fee Worksheet
Name of Project: ______________________________________________________________________________________________
Project Address or Parcel #:_____________________________________________________________ Submittal #:______________
Property Owner: _____________________________________
Address: ___________________________________________
Phone:_____________________________________________
Legal Description:
Applicant: _________________________________________
Address:___________________________________________
Phone: _______________________Fax:_________________
E-mail:____________________________________________
Architect/Engineer:_______________________________________
Address:_______________________________________________
Phone:__________________________ Fax:___________________
E-mail:_________________________________________________
Type of Work:
SUBMITTAL FEE: WORKSHEET MUST BE APPROVED BY CITY PRIOR TO SUBMITTAL OF PAYMENT.
Submit application and plans to the front counter of the City Public Works Department at 1137 W. Houser Rd. Allow 2 days for
processing. Once submittal is accepted, fees can be paid. Please include the completed form when submitting payment.
Submit 3 copies each of the following:
Plans:
# of Sheets:
x
$220.00 ═
$
Plans:
# of Sheets:
x
$140.00 ═
$
Plans:
Grading Drainage (Non Subdivision)
# of Sheets:
x
$110.00 ═
$
Plans:
Utility (Non Subdivision)
# of Sheets:
x
$90.00 ═
$
Reports:
N/A
x
$830.00 ═
$
Reports:
N/A
x
$830.00 ═
$
Reports:
N/A
x
$830.00 ═
$
Reports:
Water Research Letter Request
N/A
x
$2,500.00 ═
$
Reports:
N/A
x
$3,050.00 ═
$
Reports:
N/A
x
$1110.00 +
# of Sheets
x
$165.00 per sheet ═
$
Reports: _____________________________
N/A
x
$830.00 ═
$
Reports: _____________________________
N/A
x
$830.00 =
$
Reports: _____________________________
N/A
x
$830.00 ═
$
Total Fee: ═
$
PUBLIC WORKS DEPARTMENT USE ONLY:
Date submittal was received: __________________________ By: ______________________________________________________
Date fees were verified:_______________________________ By:______________________________________________________
Fees Paid: $ ____________________________________ Date: ____________________________ By:_________________________
Receipt Confirmation No: __________________________________________________________
Date plans were routed for review:___________________________________________________
S:\PUBLIC WORKS DEPARTMENT\Engineering\_Forms, Procedures, Checklists\Forms
Form Rev 2/21/2019
