HomeMy WebLinkAboutIowa Department of Transportaion-9/15/2014f DOT
Form 810028 (01-14)
�L PARtVENT USE ONL
APPLICATION TO PERFORM WO
WITHIN STATE HIGHWAY RIGHT-' 'Fm
Permit Number
Highway Number
(SEE ATTACHED LISTING).)
County
Black Hawk
DOT Project Number
N/A
Expiration/Completion Date
04/15/15
First Name
Richard
Middle
C
Last Name
Melick
Phone Number
319-231-0819
Ext.
Company Name
Five Star Snow Trails, Inc
Phone Number
319-231-0819
Ext.
Street Address
1314 Washington St
City/Town
Cedar Falls
State
IA
ZIP Code
50613
013) LAC`CONJPI SHE,D
Y ,
.�M
Approval is hereby requested to enter within the state right-of-way and to complete the proposed work as detailed on the attachments
and further described as follows:
Snowmobile Trail and Trail Crossing Locations as indicated on the attached listing.
Trail is located partially within the city limits of Dunkerton and Waterloo.
All crossings shall go into effect after all signs along the highway have been installed by IDOT forces.
All signs placed on the ROW by the applicant shall be ienuoved by the applicant.
and shall be located as shown on the detailed plan attached hereto. (See current lows Department of Transportation Utility
Accommodation Policy for submittal of detailed plan requirements.)
WORK SITE LOCATION
The proposed work as described above is located in Section , Twp. (SEE ATTACHED LISTING)
Range (SEE ATTACHED LISTING) '`;I on Highway No. generally located (miles)
(direction) from (city, county line, or other land line). Work proposed is more
specifically located as being from (Milepost#) and (Highway Station)
to (Milepost #) and (Highway Station) on the side of highway.
AppiIca nt Signature and Agreement
The undersigned have read the stipulations of this permit agreement as stated as well as attachments which may be included and by
signing this application agree to abide by all stipulations and to complete the work as proposed in compliance with the stipulations and
attachments within one year from the date Department approval is received for said request. Failure on the part of the applicant to
abide by the stipulations or to construct the work desired as stipulated and within the time frame stated shall render this agreement and
request null and void. The undersigned also agrees to save harmless the State of Iowa and the Iowa Department of Transportation
from any damage or losses that may be sustained by any person or persons on account of the conditions and requirements of this
agreement.
Applicant Name (First M.1., Last - Print or Type)
Richard C. MelickCl
Ap licant Signature (Handwritten)
Date
—ozb( /
CITY ACTION (IF PROPOSED WORK IS WITHIN AN INCORPORATED CITY, CITY ACTION IS REQUIRED)
"The undersigned city joins in the grants embodied in the above permit executed by the Iowa Department of Transportation on
condition that all of the covenants and undertakings therein running to the Iowa Department of Transportation shall inure to the benefit
of the undersigned city and recommends action on said permit application as noted below by the delegated city official".
DEPARTMENT OF TRANSPORTATION FINAL ACTION
Application Approved 0 Application Denied
Permit Number:
Authorized Highway District Representative
Dave Ramirez
Signature
Date
Notice of intention to commence activities on the highway rights-of-way shall be submitted by the applicant a minimum of 48 hours prior to actually commencing the activities
as herein granted by this approved application, Notice:is to be given to the following Iowa Department of Transportation representative:
Local DOT Contact Person (Type or Print Name)
Barry Thede Waterloo Area Supervisor
Phone Number
319-233-3055
Street Address
1875 West Ridgeway Avenue
City/Town
Waterloo
State
IA
ZIP Code
50704
AGREEMENTS
The applicant agrees that if granted a permit to do said work the following stipulations shall govern.
1. The applicant shall carry on the construction, repair, and maintenance with serious regard to the safety of the traveling public and
adjacent property owners and shall save the State and the Iowa Department of Transportation harmless of any damage or losses that
may be sustained by the traveling public on account of such construction, repair, or maintenance operations.
2. The applicant shall indemnify and save harmless the State of Iowa, its agencies, and employees, from any and all causes or
actions, suits at law or in equity, for losses, damages, claims, or demands, and from any and all liability and expense of whatsoever
nature, arising out of or in connection with the applicant's use or occupancy of the public highway.
3. The applicant shall hold the State and the Iowa Department of Transportation harmless of any damage that may result to said
highway because of the construction or maintenance of the facility, and shall reimburse the State or the Iowa Department of
Transportation for any expenditures that the State of Iowa or the Iowa Department of Transportation may have to make on said
highway rights-of-way on account of said applicant's construction or maintenance activity or lack thereof.
4. Traffic protection shall be in accordance with Part VI of the current Manual on Uniform Traffic Control Devices for Streets and
Highways. The applicant shall be responsible for correctly using signs as needed while work is in progress. Flagging operations are
the responsibility of the applicant.
5. Before beginning any work within the highway rights-of-way, it is the responsibility of the applicant to contact utility companies
whose installations may be affected or encountered. Contact should be made at 1-800-292-8989, a minimum of 48 hours in advance
of starting construction. If the work requested in this application should cause a need to relocate or modify an existing utility, any cost
associated shall be as negotiated between the applicant and the utility owner.
6. A copy of the approved application shall be available on the job site at all times for examination by Department of Transportation
officials.
7. The applicant shall seed and mulch all disturbed areas within the highway right-of-way and shall be responsible for the vegetative
cover until it becomes well established. Any surfaced areas such as driveways or shoulders and sodded waterways and plantings
which are disturbed shall be restored to their original condition.
8. If the proposed work results in a pool of water on the applicant's property, this pool of water will be exclusively owned, controlled,
and maintained by the applicant. That part of the modification located on highway right-of-way will be maintained by the Iowa
Department of Transportation for road purposes only.
9. The applicant shall maintain any drainage structure built within the right-of-way that is built for the benefit of the applicant and not
necessary for highway use.
10. This permit is subject to any laws now in effect as well as any new laws which may be hereafter enacted and all applicable rules
and regulations of local, state, and federal agencies.
11. This permit is subject to all the rules and regulations of the Iowa Department of Transportation, and to revocation by the Iowa
Department of Transportation at any time and at no cost to the Department, when in the judgment of the Department it is necessary in
the improvement or maintenance of the highway or for other reasonable cause.
12. The applicant agrees to give the Iowa Department of Transportation 48 hours notice of intention to start construction or perform
maintenance on the highway right-of-way. Any modification to the proposed work shall be approved by the Department prior to making
the change.
13. Unless specifically noted in item #15, all work performed within the right-of-way shall be restricted to a time frame of 30 minutes
after sunrise to 30 minutes before sunset.
14. After November24, 2008, all personnel in the highway right-of-way shall wear ANSI 107 Class 2 apparel at all times when
exposed to traffic or construction equipment.
15. All proposed work covered by this permit shall be at the applicant's expense. The applicant shall reimburse the Iowa
Department of Transportation for any materials removed from the highway right-of-way described as follows:
CITY ACTION (IF PROPOSED WORK IS WITHIN AN INCORPORATED CITY, CITY ACTION IS REQUIRED)
"The undersigned city joins in the grants embodied in the above permit executed by the Iowa Department of Transportation on
condition that all of the covenants and undertakings therein running to the Iowa Department of Transportation shall inure to
the benefit of the undersigned city and recommends action on said permit application as noted below by the delegated city
official".
Recommend Approval
0 Do Not Recommend Approval 0 None Required
Hao tten Signaa e ae, ,
X414/riAaAt
Title
Date
Type or Print Name
Authorized Official for the City of
WATERLOO
3A
IOWA DEPARTMENT OF TRANSPORTATION
Application to perform work within State Highway Right -of -Way
FIVE STAR SNOW TRAILS ASSOCIATION
Snowmobile Trail and Crossing Locations -Black Hawk County
1. Crossing of US 218 in Waterloo at Marigold Dr, milepost 176.84.
2. Marked, "ungroomed" trail along both ditches of US 218 from Marigold Dr in
Waterloo, milepost 176.84, to bridge at the north Washburn city limits.
3. Crossing under US 218 by way of bridge at north Washburn city limits, milepost
175.58
(NO SIGNING REQUIRED ON ROADWAY)
This item was completely removed and the number retained to avoid renumbering
balance of items.
Marked, "groomed" trail along east ditch only, of US 218 from the convenience
store at 7112 LaPorte Road in Washburn to East Schrock Road, southeast of
Washburn.
Crossing of US 218 at East Schrock Road, milepost 173.74.
7 Marked, "groomed" trail along both ditches of US 218 from East Schrock Road,
milepost 173.74 to LaPorte City north city limits.
8. This item was completely removed and the number retained to avoid renumbering
balance of items.
9. This item was completely removed and the number retained to avoid renumbering
balance of items.
10. Crossing of US 218 at County C57 north of Cedar Falls. Stop signs will be
placed along the trail on both sides of the highway requiring snowmobiles to stop
prior to crossing the first two lanes and also in the median to require snowmobiles
to stop before crossing the next two lanes. milepost 192.88.
11. Crossing US 218 at West Gresham Road north of Cedar Falls. Stop signs will be
placed along the trail on both sides of the highway requiring snowmobiles to stop
prior to crossing the first two lanes and also in the median to require snowmobiles
to stop before crossing the next two lanes.
12. This item was completely removed and the number retained to avoid renumbering
balance of items.
4
Black Hawk County -2014
IOWA DEPARTMENT OF TRANSPORTATION
Application to perform work within State Highway Right -of -Way
FIVE STAR SNOW TRAILS ASSOCIATION (Cont'd)
Snowmobile Trail and Crossing Locations -Black Hawk County (Cont'd)
13. Crossing of I-380/US 20 at intersection with County V49. Club will install signs
to direct Groomer and snowmobiles to cross over I-380/US 20 on the overpass
bridge and not cross at grade. "No Snowmobiling" signs will be placed along the
"on" and "off" ramps on both sides of the freeway. Trail marker signs will be
installed along the bridge deck, milepost 66.52.
13A. Along IA 281, trail exits private property via farm field driveway approx 150 ft
west of bridge over creek. Milepost 21.61
13B. The trail then proceeds east along shoulder to cross bridge, then along shoulder
approx 150 ft east of bridge to farm field driveway where it enters private
property again. This location is approx halfway between Goeller Road & Black
Hawk Buchanan Road (County V62). Milepost 21.72
14. Crossing of IA 281 at the alley between Main St and the bridge over the creek in
Dunkerton.
15. This item was completely removed and the number retained to avoid renumbering
balance of items.
15A. Crossing IA 281 (Independence Ave) east of Waterloo, approximately .90 mile
east of intersection with County V43 (Elk Run Road) & approximately .10 mile
east of property address 4914, immediately east of the blue "Litter Removal" sign,
where trail uses field driveways on either side of the highway. Milepost 4.63.
16. Crossing of IA 281 at County C57, milepost 16.64
17. Crossing of US 63 at Airline Highway in Waterloo. Milepost 166.71.
18. Crossing of US 63 approx .25 of a mile north of West Bennington Rd and approx
170 feet north of the small green highway milemarker 171. This location is a
highway "turn -around" with farm field driveways coming directly from both the
east and west farm fields, milepost 171.03.
Black Hawk County -2014
IOWA DEPARTMENT OF TRANSPORTATION
Application to perform work within State Highway Right -of -Way
FIVE STAR SNOW TRAILS ASSOCIATION (Cont'd)
Snowmobile Trail and Crossing Locations -Black Hawk County (Cont'd)
All locations shown on this application are the same as listed on the 2013 application.
Note: Marked, "groomed" trail indicates that a track driven motorized trail grooming tractor
pulling a snow drag will be operating to prepare the trail for snowmobile use and special signs
applicable to snowmobile trails will be installed.
Note: Liability insurance for the Five Star Snow Trails Association is covered on page 4 of the
"Land Owners as Additional Insureds" page on the enclosed Certificate of Insurance for the Sno
Hawks Snowmobile Club. All towns involved and the Iowa Department of Transportation are
covered by the additional insured that is listed as "THE STATE OF IOWA AND ALL OF ITS
POLITICAL SUBDIVISIONS"
6
Black Hawk County -2014