HomeMy WebLinkAboutIDOT Jefferson St crossing repair application - 7.5.2022&IOWADOT
800 Lincoln Way
Ames, Iowa 50010
Iowa Grade Crossing
Surface Repair Fund Application
Completed by (choose one): (1', City C County Is a COOP involved? C Yes (% No
This notice is to inform the Office of Rail Transportation of the Iowa Department of Transportation that the
City of Waterloo and the
Form 291302
(07-17)
(Highway Authority)
Iowa Northern Railway co- are submitting this
(Railroad)
application to use the Iowa Grade Crossing Surface Repair Fund for reconstruction of the crossing located at
Jefferson Street Waterloo Black Hawk 200786V
Street Name City County (FRA#)
General scope of project: Number of tracks to be repaired: l
Preliminary Cost Estimate:
Number of tracks to be removed: 0
Crossing Width (or surface material width): 97 ft.
(width includes footage curb to curb, thru sidewalks, recreational trails, or shoulders)
Sidewalks by quadrant (enter 1, 2 ,3 or 4) 4
Proposed surface material: Concrete
Labor:
Material:
Equipment:
Approach work:
Total
$18,000.00
$73,000.00
$9,300.00
$5,000.00
$1 05,300.00
Use of this document is to reserve a place on the Iowa Grade Crossing Surface Repair Fund waiting list. Prior to writing
an agreement, a field review with the railroad, highway jurisdiction, and Iowa Department of Transportation will be held to
agree on the details of work to be performed. The highway authority and railroad must agree to each pay 20 percent of
the total project cost.
Highway Authority
Queniuz 9-far SIs�Eo
Mayor
Name (Sign in Ink) (Title)
Quentin Hart 7/5/2022
Name (Type) (e-Mail Address) (Date)
Railroad Representative
god Tudor`
Track Manager
Name (Sign in Ink) (Title)
Rod Tudor
Name (Type)
rtudor@iowanorthem.com 5/31/2022
(e-Mail Address) (Date)
This form will then be sent to Kristopher Klop in the Office of Rail Transportation for review. For questions, e-mail Kris at:
Kristopher.Klop@iowadot.us or call 515-239-1108.
L,IOWADOT Minority Impact Statement
Form 105101 (12-15)
Pursuant to 2008 Iowa Acts, HF 2393, Iowa Code Section 8.11, all grant applications submitted to the state of Iowa that
are due beginning January 1, 2009 shall include a Minority Impact Statement. This is the state's mechanism for requiring
grant applicants to consider the potential impact of the grant project's proposed programs or policies on minority groups.
Please choose the statement(s) that pertains to this grant application. Complete all the information requested for
the chosen statement(s). Submit additional pages as necessary.
The proposed grant project programs or policies could have a disproportionate or unique positive impact on
minority persons.
Describe the positive impact expected from this project.
Indicate which group is impacted:
❑ Women ❑ Persons with a disability ❑ Blacks ❑ Latinos ❑ Asians
❑ Pacific Islanders ❑ American Indians ❑ Alaskan Native Americans ❑ Other
17 The proposed grant project programs or policies could have a disproportionate or unique negative impact
on minority persons.
Describe the negative impact expected from this project.
Present the rationale for the existence of the proposed program or policy.
Provide evidence of consultation with representatives of the minority groups impacted.
Indicate which group is impacted:
❑ Women ❑ Persons with a disability ❑ Blacks ❑ Latinos ❑ Asians
❑ Pacific Islanders ❑ American Indians ❑ Alaskan Native Americans ❑ Other
® The proposed grant project programs or policies are not expected to have a disproportionate or unique
negative impact on minority persons.
Present the rationale for determining no impact:
This project involves the repair of existing infrastructure, for the benefit of the traveling public in general.
hereby certify that the information on this form is complete and accurate, to the best of my knowledge.
Quentin Hart Mayor
(Highway Authority Name) (Highway Authority Title)
Rod Tudor Track Manager
(Railroad Representative Name) (Railroad Representative Title)
Definitions
Minority Persons," as defined in Iowa Code Section 8.11, means individuals who are women, persons with a disability, Blacks,
Latinos, Asians or Pacific Islanders, American Indians, and Alaskan Native Americans.
"Disability," as defined in Iowa Code Section 15.102, subsection 7, paragraph "b," subparagraph (1):
b. As used in this subsection:
(1) "Disability"means, with respect to an individual, a physical or mental impairment that substantially limits one or more
of the major life activities of the individual, a record of physical or mental impairment that substantially limits one or more
of the major life activities of the individual, or being regarded as an individual with a physical or mental impairment that
substantially limits one or more of the major fife activities of the individual.
"Disability" does not include any of the following:
(a) Homosexuality or bisexuality.
(b) Transvestism, transsexualism, pedophilia, exhibitionism, voyeurism, gender identity disorders not resulting from
physical impairments or other sexual behavior disorders.
(c) Compulsive gambling, kleptomania, or pyromania.
(d) Psychoactive substance abuse disorders resulting from current illegal use of drugs.
"State Agency," as defined in Iowa Code Section 8.11, means a department, board, bureau, commission, or other agency or
authority of the state of Iowa.