Impact Fee Determination Form

The Impact Fee Determination Form is used to calculate the impact fee amount due.

Impact Fee applications accompanying building permits should be submitted through Accela Citizen Access (ACA) as outlined on the Building and Safety website. (If you do not have an ACA account, please create one at – select “New Users: Register for an Account” under the login box.)

Impact Fee applications for new or replacement water or sanitary sewer taps only (without an associated building permit), please download the Impact Fee Determination Form(PDF, 84KB) and open the PDF in Adobe Reader. Once you have completed the form and saved your changes, attach the PDF file in an email to

If you have any questions or concerns about the impact fees, please contact Cynthia Roth at or call 402-441-7539. If you have questions about setting up an ACA account, please contact Justin Meyer at