HomeMy WebLinkAboutIowa Department of Transportation-Application-09.21.2009 g s/-v9
FIVE STAR SNOW TRAILS
*K -: '4 ASSOCIATION, INC
;t o 1314 Washington St, Cedar Falls, IA 50613-4153
Phone:319-266-0445 ®Cell:319-231-0819 ♦email:damelick@cfu.net
* - *
September 4, 2009
City of Waterloo
Attn: City Clerk
715 Mulberry Street
Waterloo,IN 50703
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:
319-266-0445(Home) or 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, ,`'
StrA
r
Dick Melick .
Five Star Snow Trails, Inc
Administrative Advisor
c Iowa Department of Transportation Application to Perform Work Within State Highway
Form 810028(10-08) g y
771, Highway Division I,Ames,IA 50010 Right-of-Way
FOR DEPARTMENT USE ONLY
Permit Number Highway Number County
(SEE ATTACHED LISTING) Black Hawk
DOT Project Number Expiration/Completion Date
N/A 4/15/2010
APPLICANT(INDIVIDUAL OR COMPANY) (ASSISTANCE FROM DEPARTMENT AVAILABLE UPON REQUEST)
First Name Middle Initial Last Name Phone Number
Richard C. Melick (319) 266-0445
Company Name Phone Number
Five Star Snow Trails Association (319)266-0445
Street Address City/Town State Zip Code
1314 Washington St Cedar Falls IA 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 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. Janesville and Waterloo.
All crossings shall go into effect after all signs along the highway have been installed by DOT Forces.
WORK SITE LOCATION c. w ®, ® e,,.c- + tir e °x r r 'c"r,11.
The proposed work as described above
Range on Highway No. 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#)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 condition and requirements of this agreement.
Applicant Name(First,M.l.,Last--Print or Type) App'cant Signature (Handwritten) Date
Richard C. Melick � t 9/1/2009
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 J ) Do Not Recommend Approval ! ) None Required
Auth.City Official Signature Title Date
(Handwritten)
(See attached city action sheets)
Name of Authorized City Official(Print or Type) Authorized City Official for the City of
(SEE ATTACHED CITY ACTION SHEETS) (SEE ATTACHED CITY ACTION SHEETS)
FEDERAL HIGHWAY AgMINISTRATION ACTION
{DEPARTMENT REPRESENTATIVES WILL REVIEW THE REQUEST AND OBTAIN FHWA ACTION,WHEN NECESSARY)
I 1 Recommend Approval ❑ Do Not Recommend Approval + None Required
'Authorized FHWA Rgpresentative Signature Date
(DOT Final Action&Agreements on next page)
Page 1 of 2
DEPARTMENT OF TRANSPORTATION FINAL ACTION
Application Approved fl Application Denied Permit Number
Authorized Highway District Representative Signature Date
(Type or Print): IRENE HERR. E.O.T.
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) Phone Number
DOUG LICKTrIG, GARAGE SUPERVISOR 1(319)233-3055
Street Address City/Town State ZIP Code
1875 WEST RIDGEWAY AVE. PO BOX 1888 WATERLOO IA 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'Mth Part\At 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.
'I2. 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 the
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 to hold 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 snowmobile route, including but not limited to.
its establishment, construction, use. maintenance. signing . configuration 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".
n Recommend Approval 0 Do Not Recommend Approval ❑None Required
Auth. City Official Signature Title Date
(Handwritten)
ame of Authorized City O cial (Print or type) Authorized City Official for the City of
1 1—Lt.r
2 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
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.
1 1_ 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)
1 1 A. 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-2009 4
IOWA DEPARTMENT OF TRANSPORTATION
Application to perform work within State Highway Right of Way
FIVE STAR SNOW TRAILS ASSOCIATION (Coned)
Snowmobile Trail and Crossing Locations-Black Hawk County (Cont'd)
13. Crossing of 1-380/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
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
16. Crossing of lA 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 of US 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.
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.
Black Hawk Counly-2009 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)
All locations shown on this application are the same as listed on the 2008 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 12-1-2009 to 12-1-2010 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 2009.
Black I lawk County-2009 6
4CORD,,,, CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY)
11/21/2008
PRODUCER (563) 547-2161 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
V & V Insurance Agency, Inc ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
PO Box 159 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
103 8th St E I
Cresco IA 52136- INSURERS AFFORDING COVERAGE NAIC#
INSURED INsuRERA:Da)Cota Fire Insurance Co
SNO HAWKS INC. INSURER B:
1314 WASHINGTON ST INSURERC:
INSURER D:CEDAR FALLS IA 50613- I INSURERE: 1
COVERAGES
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
AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR ADD'Ll !POLICY EFFECTIVE POLICY EXPIRATION
LTR INSRD TYPE OF INSURANCE POLICY NUMBER DATE(MM/DD/YY) DATE(MM/DD/YY) LIMITS
GENERAL LIABILITY / / / / EACH OCCURRENCE $ 1,000,000
DAMAGE TO RENTED $
X COMMERCIAL GENERAL LIABILITY
PREMISES(Ea occurrence)
X CLA! MSN1ADE �� OCCUR 3D31117 12/01/2008 12/01/2009 MED2XP(A.n ucpurs^.n) $ •
PERSONAL 8 ADV INJURY $
GENERAL AGGREGATE $ 1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $
POLICY JECOT —j LOC / / / /
AUTOMOBILE LIABILITY / / / / COMBINED SINGLE LIMIT
ANY AUTO (Ea accident) $
ALL OWNED AUTOS / / / / BODILY INJURY
(Per person) $
SCHEDULED AUTOS
HIRED AUTOS / / / / BODILY INJURY
(Per accident) $
NON-OWNED AUTOS _...
/ / / / PROPERTY DAMAGE
(Per accident) $
GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $
ANY AUTO / / / / OTHER THAN EA ACC $
AUTO ONLY: AGG $
EXCESS/UMBRELLA LIABILITY / / / / EACH OCCURRENCE $
OCCUR CLAIMS MADE AGGREGATE $
DEDUCTIBLE / / / / $
RETENTION $ $
WORKERS COMPENSATION AND / / / / TORY LIMITS OTH-
ER
EMPLOYERS'LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $
OFFICER,MEMbER EXCLUDED? / / / / E.L.DISEASE-EA EMPLOYEE $
If yes,describe under
SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $
OTHER / / / /
/ / / /
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLESIEXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
Snowmobile Club and Trail liability insurance, including liability coverage for (1) Groomer and (1) ATV (used for
trail maintenance) . Additional insured: See (5) attached sheets. Premise liability coverage is Excluded on this
policy. This policy has a $250 deductible per claim.
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL
DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT
FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE
INSURER,ITS AGENTS OR REPRESENTATIV .
AUTHORIZED REPRESENTATIVE
ACORD 25(2001/08) �4 0 b R'-/T N 1988
-M INS025(0108).05 ELECTRONIC LASER FORMS,INC.-(800)327-0545 Page r
IMPORTANT
If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this
certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an
endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such
endorsement(s).
DISCLAIMER
The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing
insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively
amend, extend or alter the coverage afforded by the policies listed thereon.
ACORD 25(2001/08)
INS025(o1o8)as Page 2 of 2
CLUB NAME; SNO HAWKS, INC.
LANDOWNERS AS ADDITIONAL INSURED FOR
CLUB CONTRACTED TRAIL USAGE ONLY
61. Mary D. Shining Trust 71. Charles Wilmot
3023 Pleasant Drive#A 2596 Joplin Avenue
Cedar Falls,IA 50613 Denver,IA 50622
62. William A. Shining Trust 72. Raymond&Pauline Youngblut
3023 Pleasant Drive#A 6732 LaPorte Road
Cedar Falls, IA 50613 Waterloo, IA 50706
63. Ronald Steege 73. Tim Youngblut
9321 Logan Avenue 6905 LaPorte Road
Waterloo, IA 50703 Washburn, IA 50706
64. Eugene E. &Jean M. Stokes 74. David M. &Nancy J. Zeien
8225 Ford Road 4622 West Cedar Wapsi Road
Cedar Falls, IA 50613 Cedar Falls, IA 50613
75. The State of Iowa&All of its political
65. Tall Pine Farms,Inc. Subdivisions
7411 North Raymond Road Wallace State Office Building
Dunkerton,IA 50626 Des Moines,IA 50319
66. Michael&Kathy Tellinghuisen 76. Five Star Snow Trails Association
7611 North Union Road 5912 Aster Lane
Janesville,IA 50647 Waterloo,IA 50701
67. Clifford R. &L. Marcella Trent 77. City of Janesville Iowa
8339 Leversee Road 227 Main Street
Cedar Falls, IA 50613 Janesville, IA 50647
68. Alan&Marilyn Walker
1303 East Bennington Road
Waterloo, IA 50703
69. Washburn BP Store
7305 LaPorte Road
Washburn,IA 50702
70. Waterloo Industrial Development
10 West 4th Street
Waterloo, IA 50701
Page 4 of 4
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