Public Works Plan Review Submittal Form - City Of Astoria Engineering Division
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1Public Works Plan Review Submittal Form
City of Astoria – Engineering Division
Plan Review #:
___________
Date Submitted:
___________
1095 Duane Street, Astoria, OR 97103
Date Approved:
___________
Phone: (503) 338-5173 Fax: (503) 338-6538
Web:
PROJECT INFORMATION
Project Name:
Street Name(s)/Location:
Description of Work:
APPLICANT
Send Correspondence to this Contact
Contact Name:
Business Name:
Address:
City/State/ZIP:
Phone:
Email:
ENGINEER
Send Correspondence to this Contact
Name:
PE Lic. #:
Business Name:
Address:
City/State/ZIP:
Phone:
Email:
INFRASTRUCTURE CONSTRUCTION COST
PLAN REVIEW
Preliminary Construction Cost (Prepared by ENGINEER & attached):
Note: A public works plan review fee of 1% of the preliminary construction cost ($500 minimum) will be required with the plan
submittal. The construction cost used to calculate the required fee is associated with all improvements made in the public right-of-way or
public improvements constructed in easements. This includes but is not limited to road, curb, sidewalk, driveway, ADA ramps, grading,
erosion control, storm drainage, sanitary sewer, water, street light, retaining structures, signage, and striping.
Applicant Signature:
Date:
STAFF USE ONLY
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Completeness Review
3 Plan Sets
Completed by PE
Design Standards
Cost Estimate Provided
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Plan Review Routing
PW Operations
PW Engineering
AFD
Building/Planning
Public Works Operations Approval:
Date:
Public Works Engineering Approval:
Date:
Public Works Plan Review Fee:
Construction Permit Fee:
Note: A construction permit fee of 2% of the estimated construction cost will be required prior to commencing construction activity. The
fee will be documented above and collected in lieu of the Right-of-Way Permit Fee of $100 (Street-cut fees still apply). The estimated
construction cost associated with the construction permit needs to include any scope changes associated with the plan review process.
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4/21/17
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