HomeMy WebLinkAboutIowa Department of Transportation-9/7/2010Iowa Department of Transportation
Form 810028 (10-08)
Highway Division 1 Ames, IA 50010
FOR DEPARTMENT USE ONLY
Application to Perform Work Within State Highway
Right -of -Way
Permit Number
Highway Number
(SEE ATTACHED LISTING)
County
Black Hawk
DOT Project Number
N/A
Expiration/Completion Date
4/15/2011
APPLICANT (INDIVIDUAL OR COMPANY
ASSISTANCE FROM DEPARTMENT AVAILABLE UPON RE UES
First Name
Richard
Middle Initial
C
Last Name
Melick
Phone Number
(319) 231-0819
Company Name
Five Star Snow Trails Association
Phone Number
(319) 231-0819
Street Address
1314 Washing ton St
City/Town
Cedar Falls
State
IA
Zip Code
50613-4153
WORK TO BE ACCOMPLISHED
Approval is hereby. requested to enter within the state right of way and to complete the proposed work as detailed
on the attachmerlts`and further described as follows:
Snownobile Trail and Trail Crossing locations as indicated on the attached listing.
Trail is located partially within the city limits of Dunkerton. Janesville and Waterloo.
All crossisngs shall go into effect after all signs along the highway have been installed by DOT Forces.
WORK SITE LOCATION SEE ATTACHED LISTING
The proposed work as described auove r; iouateu oeuuui�
, Twp.
Range on Highway No. generally located (miles)
(city, county line or other land line). Work proposed is more
(direction) from
specifically located as being from (Milepost#) and (Highway Station)
to (Milepost#) and (Highway Station) on the side of highway.
Applicant 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 lowa Department of Transportation from any damage or losses that may be sustained by any person or persons on
account of the concgitiorla and requirements of this agreement.
Applicant Name (fir f, M.L, Last—Print or Type)
Applicant Signature (Handwritten)
Date
Richard C. Melick
9/2/2010
CITY ACTION (IF PROPOSED WORK IS WITHIN AN INCORPORATED CITY, CITY ACTION 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
Auth. City Official Signature
(Handwritten)
Do Not Recommend Approval
None Required
Title
(See attached city action sheets)
Date
Name of Authorized City Official (Print or Type)
(SEE ATTACHED CITY ACTION SHEETS)
Authorized City Official for the City of
(SEE ATTACHED CITY ACTION SHEETS)
FEDERAL HIGHWAY ADMINISTRATION ACTION
(DEPARTMENTIREPRESENTATIVES WILL REVIEW THE REQUEST AND OBTAIN FHWA ACTION, WHEN NECESSARY)
I
Recommend Ppmval n Do Not Recommend Approval None Required
Authorized FHWA Representative Signature
Date
(DOT Final Action & Agreements on next page)
Page 1 of 2
DEPARTMENT OF TRANSPORTATION FINAL ACTION I
n II
Application Approved I Application Denied
Permit Number
Authorized Highway District Representative
(Type or Print):
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)
DOUG LICKTEIG, GARAGE SUPERVISOR
Phone Number
(319) 233-3055
Street Address
1875 EAST RIDGEWAY AVE, PO BOX 1888
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 applicants 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 November 24, 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 th
Iowa Department of Transportation for any materials removed from the highway right-of-way described as follows:
16. The following special requirements shall apply to this permit:
PLEASE NOTE: The sponsor agrees tohold harmless the State of Iowa and the Iowa Department of
Transportation and 'to indemnify them from any claim, demand or action by or on behalf of any person or entity.
arising out of or in connection with anything having to do with the sno«znopbile route, including. but not limited
to, its establishment, construction, use, maintenance, signing, cofiguration or existence.
Disclosure Statement The information furnished on this form will be used by the Department of Transportation to determine
approval or denial of the application. Failure to provide all information will result in denial of the application. Information furnished
is public information and copies may be provided to the public upon request.
Page 2 of 2
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".
LTJ" Recommend Approval
0 Do Not Recommend Approval
0 None Required
(Auth}: Official Si u
Ha,. ,en)
G%uf
nue
�RfriIQol0
game of Authorized City Official (Print or type)
V tz2j' A . t & -L
Authorized City Official for the City of
WATERLOO
3B
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)
4. Marked "ungroomed trail along east ditch only of US 218 from bridge listed in item # 3 to
farm driveway approx 300 ft north of Washburn city limits and immediately north of
residence with street number 6605.
5. 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.
6. 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. Crossing under US 218 at Broadway St in Waterloo, mile post 185.8. (See item 9 below )
(NO SIGNS REQUIRED ON US 218)
9. Marked, "ungroomed" trail along south ditch of Broadway St from US 218 southbound "on
ramp" to the US 218 northbound "off ramp".
10. Crossing of US 218 at County C57 north of Cedar Falls, milepost 192.88.
11. Crossing under US 218 through concrete box culvert at intersection with West Marquis Rd
(7th St) in Janesville, milepost 194.90. Install temporary wooden trail bridge across rocks in
west ditch at opening of culvert. (NO SIGNING REQUIRED ON ROADWAY)
11A. Temporary bridge mentioned in item 11 will be removed afer the snow season ends.
12. Marked, "ungroomed" trail along west ditch only of US 218 from above crossing, south
approx 300 ft.
Black Hawk County -2010 4
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 Sycamore St in Dunkerton.
Milepost 13.75
15. Crossing of IA 281 at the Kwik Star Convenience Store at the south edge of Dunkerton.
Milepost 13.27
15A. **Crossing IA 281 (Independence Ave) east of Waterloo, approximately .90 of a mile east
of intersection with County V43 (Elk Run Road) & approximately .10 of a 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. Marked, "ungroomed" trail along both ditches of US 63 from Hudson city limits north to
milepost 158.04, south of US 20 interchange.
18. Crossing of US 63 south of interchange with US 20 at milepost 158.04.
19. Marked, "ungroomed" trail along west ditch only ofUS 63 in Waterloo from milepost 158.04,
crossing under US 20, and proceeding north to Ridgeway Ave.
20. Crossing of US 63 at Ridgeway Ave in Waterloo, milepost 159.58.
Black Hawk County -2010 5
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)
21. Marked, "ungroomed" trail along the east ditch only of US 63 from Ridgeway Ave in
Waterloo, milepost 159.58, south approx 500 feet to the parking lot of Heartland Inn Motel.
Trail will end at that point.
22. Crossing of US 63 at Airline Highway in Waterloo, milepost 166.71.
23. Crossing of US 63 approx .25 miles 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.
* Item 13A shown on the 2009 application has been modified and item 13B added to better clarify
the location.
* * Item 15A has been modified to better clarify the location
All other locations shown on this application are the same as listed on the 2009 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 listed as "THE STATE OF IOWA AND ALL OF ITS POLITICAL
SUBDIVISIONS".
Note: A copy of the Insurance for the Sno Hawks Snowmobile Club for the current year is enclosed.
Insurance renewal for year 12-1-2010 to 12-1-2011 is in process. Policy has not yet been issued.
A copy of the approved policy will be provided to each entity involved upon receipt of the policy,
which is expected to be sometime during the month of December 2010.
Black Hawk County -2010 6
September 1, 2010
City of Waterloo
Attn: City Clerk
715 Mulberry Street
Waterloo, IA 50703
FIVE STAR SNOW TRAILS
ASSOCIATION, INC
1314 Washington St, Cedar Falls, IA 50613-4153
Phone: 319-266-0445 ♦ Cell: 319-231-0819 ♦ email: damelick@cfu.net
Enclosed for your consideration is the Application to the Iowa Department of Transportation (IDOT)
for renewal of the permit to establish and sign a snowmobile trail within the right of way of state
highways. A portion of that trail resides within the city limits of Waterloo. The IDOT requires that
each affected city approve the application before being processed by the Department. Page 3B of the
application has a block for the signature of the responsible individual representing Waterloo.
PLEASE USE THIS PAGE FOR THE CITY SIGNATURE. DO NOT -COMPLETE THE
SIMILAR SECTION SHOWN ON PAGE 1 OF THE APPLICATION:
Permits are issued for one season only and must be renewed each year. This application is the same
as the one which was approved last year for the city of Waterloo. Items 1, 2, 8, 9 on page 4 and
items #17, 18, 19, 20, 21, and 22 on page 5 are the only items which affect Waterloo.
If you have any questions concerning the application and related paperwork, you may contact me at:
319-231-0819(Cell) or e-mail to: damelick@cfu.net
I would appreciate it very much if city action could be taken at the next Council meeting, if Council
action is required. The IDOT is short on staff and it could take them some time to take their action,
so it is imperative that we get the application in their hands as soon as possible, so as to beat the
freezing temperatures and first snowfall with signing of the trail.
Please return to me in the enclosed, "postage applied" envelope as soon as possible after action has
been taken by city officials.
Thank you for your` assistance with this matter.
Sincerely,
Dick Melick
Five Star Snow Trails, Inc
Administrative Advisor