HomeMy WebLinkAboutIDOT Mullan-Sycamore Application - 8.7.2023Rev. 5/18
IOWADOT
Application for SITE -SPECIFIC
TSIP FUNDS
GENERAL INFORMATION DATE:
Mullan Street (US 63) & Sycamore Street Intersection
Location / Title of Project Signalization
Applicant City of Waterloo
Traffic Operations Interim
Contact Person Mohammad Elahi Title Director
Complete Mailing Address 625 Glenwood street, Waterloo, Iowa 50703
moham mad.elah i@waterloo-
Phone (319) 291-4440 E-Mail ia.org
(Area Code)
If more than one highway authority is involved in this project, please indicate and
fill in the information below (use additional sheets if necessary).
Co-Applicant(s)
Contact Person
Complete Mailing Address
Title
Phone E-Mail
(Area Code)
PLEASE COMPLETE THE FOLLOWING PROJECT INFORMATION:
Funding Amount
Total Safety Cost
Total Project Cost
Safety Funds Requested
$ 262,000
$ 262,000
$ 262,000
Does this project appear on a Safety Improvement Candidate List or is there a safety
study recommendation for this project?
Rev. 5/18
❑Yes — Explain
No
Rev. 5/18
APPLICATION CERTIFICATION FOR PUBLIC AGENCY
To the best of my knowledge and belief, all information included in this application is true and
accurate, including the commitment of all physical and financial resources. This application
has been duly authorized by the participating public agency(ies). I understand the attached
resolution(s), where applicable, binds the participating public agency(ies) to assume
responsibility for any additional funds, if required, to complete the project. In addition, the
participating public agency(ies) agrees to maintain any new or improved public streets or
roadways for a minimum of five years.
I understand that, although this information is sufficient to secure a commitment of funds, a
firm contract between the applicant and the Department of Transportation is required prior to
the authorization of funds.
Representing the City of Waterloo
Signed:
Attest:
Quet /iz 9- irf si�rvio
8/7/2023
Signature Date Signed
Quentin Hart
Printed Name
xelTy FefchCe
8/7/2023
Signature Date Signed
Printed Name