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HomeMy WebLinkAboutFive Stars Trail Association, Inc DNR Trail Application-)k • Y September 27, 2017 City of Waterloo Attn: City Clerk 715 Mulberry Street Waterloo, IA 50703 FIVE STAR SNOW TRAILS ASSOCIATION, INC. 2202 Minnetonka Drive, Cedar Falls, IA, 50613-1522 Ph: 319-266-2929(H) • 319-610-1171(C) ♦ Email: frenchtdl(d vahoo.com 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 3A of the application has a block for the signature of the resnons dual renrearai} W ted r.s , PLEASE, USE f. .PAGE,.EOi "ILE: CITY S1GNAJURE. 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 on page 4 and item #17 on page 5 are the only items that currently affect Waterloo. See "Special Insurance Information that is attached to this letter". If you have any questions concerning the application and related paperwork, you may contact me at: 319-610- 1171(Cell) or e-mail to: frenchtdl@Yahoo.com I would appreciate it very much if City action could be taken at the October .4 Council meeting, if Council action is required. It is imperative that we get the application in the hands of the IDOT as soon as possible, so as to beat the freezing temperatures and first snowfall with installation of the signs along the trail. Please return the signed copy 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, %D7c Tony D French Five Star Snow Trails Assoc., Inc. Administrative Advisor &10WADOT Forth 810028 (01-14) APPLICATION TO PERFORM WORK WITHIN STATE HIGHWAY RIGHT-OF-WAY FOR DEPARTMENT USE ONLY Permit Number Highway Number (SEE ATTACHED LISTING) County Black Hawk DOT Project Number N/A Expiration/Completion Date 04/15/18 APPLICANT (INDIVIDUAL OR COMPANY) [ASSISTANCE FROM DEPARTMENT AVAILABLE UPON REQUEST) First Name Tony Middle D Last Name French Phone Number 319-610-1171 Ext. Company Name Five Star Snow Trails, Inc Phone Number 319-610-1171 Ext. Street Address 2202 Minnetonka Drive City/Town Cedar Falls State IA ZIP Code 50613 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 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 removed by the applicant. and shall be located as shown on the detailed plan attached hereto. (See current Iowa 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 Range (SEE ATTACHED LISTING) on Highway No. , Twp. (SEE ATTACHED LISTING) 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 it) 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 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.L, Last- Print or Type) Tony D. French ApplicantJ&4 c d mate raj / r`D (*�� 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 Handwritten Signature Title Date Type or Print Name (SEE ATTACHED CITY ACTION SHEETS) Authorized Official for the City of (SEE ATTACHED CITY ACTION SHEETS) FEDERAL HIGHWAY ADMINISTRATION ACTION (DEPARTMENT REPRESENTATIVE WILL REVIEW THE REQUEST AND OBTAIN FHWA ACTION, WHEN NECESSARY) 0 Recommend Approval 0 Do Not Recommend Approval 0 None Required Authorized FHWA Representative Signature Date (DOT Final Action and Agreements on next page) Page 1 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". 0 Recommend Approval 0 Do Not Recommend Approval 0 None Required Handwritten Signature Title M210V Date 100 I Type or Print Name Qu.e.0-i A N +. 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 east ditch of US 218 from Marigold Dr in Waterloo, milepost 176.84, to bridge at the north Washburn city limits. 3. Install a temporary bridge in the east ditch of US 218 over the small creek at the north Washburn city limits. (NO SIGNING REQUIRED ON ROADWAY) 4. This item was completely removed and the number retained to avoid renumbering balance of items. 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. 7. Crossing of US 218 at East Schrock Road, milepost 173.74. Marked, "groomed" trail along both ditches of US milepost 173.74 to LaPorte City north city limits. 8. This item was completely removed and the number balance of items. 9. This item was completely removed and the number balance of items. 10. This item was completely removed and the number balance of items. * 11. This item was completely removed and the number balance of items. 12. This item was completely removed and the number balance of items. 4 Black Hawk County-2017.docx 218 from East Schrock Road, retained to avoid renumbering retained to avoid renumbering retained to avoid renumbering retained to avoid renumbering retained to avoid renumbering 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) * This item was completely deleted due to re construction of the interchange of US 218 and County Road C57. There is no longer snowmobile access to that area. Balance of items are the same as shown on the 2016 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 the "Land Owners as Additional Insureds" page on the enclosed Certificate of Insurance for Sno Hawks, Inc. 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-2017.docx ACO .__p, I DAM (MMIY IUUYYY) `C _....-1 CERTIFICATE OF LIA EILITY INSURANCE 10/03/2016_.... THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), ALITIIORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. ifi I If the ccertificateh holder Is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGA ,ION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on does not confer rights to the certificate holder in lieu of such endorsement(s) this cr. I Ica ,_. PRODUCER - -- — II;((t' ' Dale a.(e, V Insurance Agency Inc HONriA F,r.563-547-2161 (A//C NA): 563-547-2046 „Ai; Insure rwo(o /lovin:. corn Po Oox 159 Creisco IA 52136 INSURER(SI AFFORDING COV ERAGE INSURER A: Dakota Fire Insurance Co, SIV© HAWKS INC 5912 ASTER LANE WATERLOO IA 50701 INSURER f: NAY; e 10863 i INSURER D INSURER E INRIIRER F: _. __ _.._......„.. L^.-OVERF.C4ES I CERTIFICATE NUMBER: 201610031510125 15 REVISION NUMBER: _ THIS IS TO CE�'i71EY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INER1 ADDL.SUER POLICY EFF POLICY EXP LIP.lIiS LTR TYPE OF INSURANCE (qcn WW1 POLICY NUMBER (MM[DD/YYYY[ (MMIDDRYYYI _ X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE 1,000,000 X %J .RIJIto el OCCUR rl I re;.Pe. 0 MED 0:401r:. 0 ) P) 0 4D78753 10101/2010 10101120'1'7 I Y 4A N INJURE 0 IISIT A PRD- l J001 � (ITOMOBILE (.IADILITY ANY AUDI) OWNED SCHEDULED 400505 OfILY AUTOS [-[[NEC NON -OWNED AUTOS ONLY AUTOS ONLY UMBRELIIA UAB OG[ IP. EXCESS HAD CLAWS -MADE 03D 1 RF ! NTIUN3 WORKERS COtPENSAUON AND EMPLOYE SI LIABILITY YIN ANYPROPRIET RIPARTNERIEXECUTIVE 0fFICERAIEM EREXCLUDEO? ( I NIA (Mandatory In n . _ )' 0 ESE, describe wider rr5 plPT tl H OPERATIONS beic. DESCRIPTION OF UP 0E( 1EHAL 0080RGATL 1,000,000 pRoDucrs -0000P/OP hCG 0 STOUT 0INJURY (Par sEr002) 0 010lrY INJURY (PBI EEEOenq • FEAC,H 00810RRENK;E .8GREGATE l 3000 0080030 ! 1 0098450.00EMPLOYEE 'i EOL'EtE4L - POLICY 61*ie RATIONS I LOCATIONS! VEHICLES (ACORD 501, Additional Remarks Schedule, may he attached it mc:u space is required) Snowmobile Club and Trail Liability Insurance, including liability coverage for (2) groorners and (1) ATV (used for trail maintenance only). Additional insured for trail usage: City of Janesville, 227 Main Street, Janesville IA 50647; Five Star Snow Trails Assn, 5912 Aster Lane, Waterloo IA 50701; The State of Iowa & All of its Political Subdivisions, Wallace State Office Building, Des Moines IA 50319. See attached form CG7501 regarding contracted landowners for trail usage. Preni'ise liability coverage is Excluded on this policy CERTIFICATE HOLDER CANCEL! AT ION SHOULD ANY OE THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AU❑MON/ZED REPRESE11TARV[ 0i98B-2015 ACORD CORPORATION. All righ¢s reserved. ACORD 25 (2096103) The ACORD narne and logo are registered narks of ACORD COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ IT CAREFULLY ADDITIONAL INSURED - DESIGNATED PERSON OR ORGANIZATION - VICARIOUS LIABILITY This endorsement modifies insurance provided under tile following COMMERCIAL GENERAL LIABILITY COVERAGE FORM SCHEDULE Narnz$ Of Additional Insured Person(s) Or Organization(s): ALL STATE SNOWMOBILE ASSOCIATION AND SNOWMOBILE CLUB DESIGNATED TRAIL LANDOWNERS FOR USE OF LAND FOR SNOWMOBILE TRAIL liSAGE ONLY. • Inforr cation required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section U — Who is An Insured is amended to in- clude as an additional insured the person(s) or organization(s) shown in the Schedule, but only with resi*ct to liability for "bodily injury", "property dam- age"1 or "personal and advertising injury" caused, in whole, by your acts or omissions or the acts or omis- siona of those acting on your behalf: 1, ii:the performance of your ongoing operations; 2. ri connection with your premises owned by or [tented to you. However, the. insurance afforded to such additional loaded only applies to the extent permitted by law. B. This Hsurance does not apply to any "bodily injury", ilproterty damage" or "personal and advertising in- jury resulting from any act or emission by, or willful misconduct of the additional insured shown in the Schedule, whether the sole or a contributing cause of thk loss. The coverage afforded to the additional insaked is limited solely to the additional insured's "vicarious liability" that is a specific and direct result of ydur conduct. CG7501(-10-13) "Vicarious liability" as used in this endorsement moans liability that is imposed on the additional in- sured solely by virtue of its relationship with you, and not due to any act or omission of the additional in-- sured. C. ‘Afith respect to the insurance afforded to these ad-- ditional insureds, the following is added to Section 111— Limits Of Insurance: If coverage provided to the additional insured is re- quired by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance. 1. Required by the contract or agreement; or 2. Available under the applicable Limits of Insur-- aiic shown in the Declarations; whichever is less. 'r his endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. Includes copyrighted material of 150 Properties, Inc. with its pennitlsion. Pogo 'I of I CLUB NAME: SNO HAWKS, INC. LANDOWNERS AS ADDITIONAL INSURED FOR CLUB CONTRACTED TRAIL USAGE ONLY City of Janesville Iowa 227 Main Street Janesville, IA 50647 The State of Iowa & All of its political Subdivisions Wallace State Office Building Des Moines, IA 50319 Five Star Snow Trails Association 5912 Aster Lane Waterloo, IA 50701 Page 1 of 1