HomeMy WebLinkAboutIDOT Mobile and Sumner Grant App - 8.5.2024C4IowADoT
Application for TRAFFIC CONTROL DEVICE
TSIP FUNDS
GENERAL INFORMATION DATE: July 26, 2024
INTERSECTION OF MOBILE STREET AND SUMNER
STREET OBSOLETE SCHOOL SIGNAL
Location / Title of Project REPLACEMENT
Applicant City of Waterloo
Contact Person Tina Schellhorn Title Associate Traffic Engineer
Complete Mailing Address 625 Glenwood Street
Waterloo, IA 50703
Phone (319)291-4440 E-Mail Tina.schellhorn@waterloo-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 Title
Complete Mailing Address
Phone E-Mail
(Area Code)
PLEASE COMPLETE THE FOLLOWING PROJECT INFORMATION:
Funding Amount
Total Safety Cost $ 120,000
Total Project Cost $
Safety Funds Requested $ 120,000
Additional Project Safety Documentation (when available):
❑ Project information sheet(s) or "Risk Score">50% from County/City's Local Road Safety Plan
❑ FHWA SS4A Safety Action Plan or similar comprehensive transportation safety plan
Iowa DOT TEAP Study or similar analysis and concept
❑ Project intersection or segment with High or Medium PCR Level (PCR-All or PCR-Severe) from
the Iowa DOT Potential for Crash Reduction (PCR) web -based map tool https://per.iowadot.gov/
Potential for Crash Reduction (PCR) Information
Intersection ID
(1234567890)
or Segment ID (1234)
Intersection or Segment
PCR
Level
-'sh
PCR
Level
Medium
R- PCR-
AlI Sever
value
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:
Ottertail Ilar
DIGITALLY
SIGH
8/5/2024
Signature
Quentin Hart
Printed Name
Date Signed
Arany 9 96y °��"` 8/5/2024
a SIGNEG
Signature Date Signed
Nancy
Printed Name