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HomeMy WebLinkAboutIDOT Five Star Snow Trails Inc.-10/17/2016• Form 8':0028 ;o1-14) APPLICATION TO PERFORM WORK WITHIN STATE HIGHWAY RIGHT-OF-WAY FOR DEPARTMENT USE ONLY Permit Number 74- 20/4 Highway Number (SEE ATTACHED LISTING) County Black Hawk DOT Project Number N/A Expiration/Completion Date 04/15/17 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 319-6/0-1171 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 Trait and Trail Crossing Locations as indicated on the attached listing. Trail is located partially within the city limits ofDunkerton and Waterloo_ All crossings shall go into effect after all signs along the highway have been installed by IDOT forces_ AH 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 , Twp. (SEE ATTACHED LISTING) Range (SEE ATTACHED LISTING) on Highway No. Zip 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 lowa 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.I., Last - Print or Type) Tony D. French Applicant Signaure (Handwritten) Date y• c7'L; CITY ACTION (IF PROPOSED WORK IS WITHIN AN IiORPORATED CITY, CITY ACTION 1S 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 El Do Not Recommend Approval 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 ADMLNISTRATION ACTION (DEPARTMENT REPRESENTATIVE WILL REVIEW THE REQUEST AND OBTAIN FHWA ACTION, WHEN NECESSARY) Recommend Approval Do Not Recommend Approval E None Required Authorized FHWA Representative Signature Date (DOT Final Action and Agreements on next page) Page 1 of 2 DEPARTMENT OF TRANSPORTATION FINAL ACTION Application Approved E Application Denied Authorized Highway Disthct.Representative Daryl Erickson, EOT azokrz- Permit Number. ')aj Date/ / ////r7/6 Notice of intention to commenoacbvities on the, highway rights -or -way shall be submitted by the applicant a minimum of 48 hours priory) actually rmmiendng the ae4vities :. as herein granted by this approved application. Notice is to be given to thefollowing Iowa Department of Transportation representative: Local DOT Contact Person (Type or Print Name) Barry Thede Waterloo Area Supervisor Phone Number 319-233-3055 Street Address 1875 West Ridgeway Avenue City/Town Waterloo State IA ZIP Code 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 lowa 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 thepublic highway. a 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 shalt reimburse the State or the Iowa Department of Transportation for any expenditures that the State of lowa or the Iowa Department of Transportation may have to make on said highway rights-of-way on account of said applicant's construction or maintenance activity or lack thereof. 4. Traffic protection shalt be in accordance with Part VI 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 b. Before beginning any work within the highway rights-of-way, it is the responsibility of the applicantto 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 alt 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 shalt 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 lowa 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.foi 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, 12 The applicant agrees to give the Iowa Department of Transportation 48 hours notice of intention to start construction or perform maintenance an 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: 4B, The following special requirements shall apply to this permit: LEASE NOTE: The sponsor agrees to hold harmless the State of Iowa and the Iowa Department of Transportation andto 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 usedby. 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 furnishedis public information and copies may be provided to thepublic 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". NRecommend Approval D Do Not Recommend Approval 0 None Required Handwritten Signature tiV 1 - Title -- �c Date 1°71i /1 L Type or Print Name (QM C4 r C"� -0-diii-- Authorized Official for the City of WATERLOO 3A TO: CITY CLERK In re-evaluating the process that we have been following for many years, we have come to the conclusion that it is possible to substantially reduce the amount of paper copies we have been generating. Starting with this APPLICATION TO PERFORM WORK WITHIN STATE HIGHWAY RIGHT-OF-WAY, we are requesting that you retain all of the documents included with this package except the single sheet that is signed by your City Official. It is suggested that you make a copy of the signed sheet to keep with the package and mail the original back to us in the postage applied envelope. This package of material becomes your temporary file copy, pending approval by the IDOT. When we have received the signed copy from the IDOT with the permit number, a final copy of the IDOT form 810028 will be sent to replace the copy you received with this package. Last evening, we completed our processing of the application and ready to deliver today. This morning we received a copy of the 2016 insurance certificate from the insurance agency. Do to this, we have made pen changes to the letter of instructions. We hope that this is not too confusing, but in the end it will "save the trees" by reducing the n»mber of paper copies produced. Thank you. October 4, 2016 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: frenchtdMvahoo.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 responsible individual representing_ Waterloo. PLEASE USE THIS PAGE FOR THE CITY SIGNATURE. 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. 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' 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, 7o D 7w e Tony D French Five Star Snow Trails Assoc., Inc. Administrative Advisor 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. 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. This item was completely removed and the number retained to avoid renumbering balance of items. 9. This item was completely removed and the number retained to avoid renumbering balance of items. 10. This item was completely removed and the number retained to avoid renumbering balance of items. 11. Crossing US 218 at West Gresham Road north of Cedar Falls. Stop signs will be placed along the trail on both sides of the highway requiring snowmobiles to stop prior to crossing the first two lanes and also in the median to require snowmobiles to stop before crossing the next two lanes. 12. This item was completely removed and the number retained to avoid renumbering balance of items. 4 Black Hawk County-2016.docx xooP'9I0Z-Xunoo *wen IDEIH "£0" ILT lsodaliuu 'smog uue; 450m put lsea agl gloq uio.g Ailoonp 8uiuloo sX2Manup Nag uuE3 glint „punoze-uznl„ JC2Mg2[I 2 st uoilEooi stgj •ILI za)Tzeuuaituz 6eM0tq uaa18 gems ag1 Jo quou 4003 OL T xoidde pue psj uol2utuuag Isom jo quou aqui 2 Jo SZ• xozdde £9 Sf1Jo 8utssoIJ "IL"991 lsodo qt4 •oopalem uI Xenulggi amply 42 £9 sap 8utssozj t9"9T isodattul '/g3'clunop 12 I8Z yI3o 8uissoxj "8I LI "9T "£9"t isodaiilni •JCemg2tq Og4 Jo apis za ma uo s,C2Manup piag sasn Feu alagm `u8is „tunouza21 zajwi„ aniq amp 1520 Fial2tpaunut `tT6t ssazppe ,Cuadozd jo 4520 01iul 0T• ,CTOleunxoldd2 ag (p2o2I una NTH) £tA )(lunop gum uogOaslalui 30 3520 0111u 06"1CT032unxozdd2 `oopalwm jo ma (any aouapuadapuI) I8Z `dI 8uisso1j "FAST -sulali jo aoueieq 8uuaqumuaz pion 0l paurela4 xaqumu alp pue p0AOU10z Aialaidiuoo sem uzalt an •SI •uouaap.mu ut )10010 0414 zano a8puq all put lS 4.4t2Tnl uaaMlaq .Cane alp 42 T8Z VI Jo 8uissozj ZL"IZ lsodaliN "(Z9A 1ClunoJ) peon ueu2gong 1M2H aIo2Ig ay p2ox 1011000 uaaMlaq XeM3i2q xozdd2 sir 410p:2001 sun •ui282 ,Cuadozd alEnud s103ua It azatM A2Manup Nall uu23 01 a8ppq JO 3520 a OST xoldd2 zapinogs 8uoie 0044. `08puq ssoza 04 lapinogs 8uoie is2a spaaoozd uagl Iraq aqz tT "g£I I9"TZ lsodaiiN '310010 JOAO a8pug3o 150m u OSI xoldd2 ,C2Manup piag 1.11123 2121. 4iodozd 012nud suxa I1.2' `T8Z yI 8u0id •V£1 "ZS"99 lsodalluz `aloap a8puq aql 8uop2 pa -plait aq Ilim su2is 10'11eux 11211, •,f2Maaz3 agl 3o sapis wog uo sdurei ,33o„ put «410„ agl Zuo12 pao2ld aq 1PM su2is „8uiligoulmoug oN„ •ap2z8 32 saw lou puu aEpuq ssedlano 0ql uo OZ S11/08£ -I JOAO 55010 01 sOiigouzmous put 101U00 ° loanp of suis II23suI II!M quip -6tA Xlunoj 1{ITM uouaaslalui 12 OZ Sf1/08£-I30 8uisso13 £1 (p juoj) AunoD xm1I xauig-suopEaoT tu►sso. 3 pun Rut ajlgoumoug (p,1uoj) MOIIVIDOSSV S'IIV2i,L MOMS IMS aAI3 .Cent;o-IgBm B2mg8►g alms u►gltn+ xio,b tuaq;.uad oa uop2aiiddv MOIIVIIIOdSMVIIL 30 .LMaITIIVdaa VMOI 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) _ t 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 1111111111 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 that is listed as "THE STATE OF IOWA AND ALL OF ITS POLITICAL SUBDIVISIONS". 6 Black Hawk County-2016.docx AC ® CERTIFICATE OF LIABILITYINSURANCE DATE IMM/DD/03/20 .✓ 10/03/2016 THIS CERTIFICATE IS ISSUED ASA 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), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) must have ADDITIONAL INSURED provisions or be endorsed. 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 ofsuch endorseent(s). PRODUCER vGN!_P T Dale Tr2Cfis V & V Insurance Agency Inc DONNE rn563547-2161 AX Po Box 159 aB.N .Fri. rAiq No, 563547-2046 ADKpl: Insurance(a;vandvos-cem RUF 3i. Cresco IA 52136 INSURED SNO HAWKS INC 5912 ASTER LANE WATERLOO IA 50701 INSURERf51AFFORDINGCOVER4GE NAICN INSURER A: Dakota Fire Insurance Cc. ' 10863 INSURER 9: INSURER C INSURERO: INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER: 20161003151012919 REVISION NUMBER: THIS IS TO CERTIFY 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 15 SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR'. AOOL SUBR'. POLICY EFF _ POLICY EXP LTRI TYPEGF INSURANCE issn yD. POLICY NUMBER - rmminernnm (MMAOIYYY . LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE 1.000.000 A X CLAMS -NUDE OCCUR cRRM( OE �twmn 0 AMA. NI MED 5X? (My ona peronl 5 0 4D78753 '.10/01/2016(10/01/2017 PERSONAL RADV INJURY t 0 01F.LI.. _ IT PLIES P05 PRO- 100 -COT AUTOMOBILE LIABILITY ANY AUTO UNWED SCHEDULED AUTOS ONLY AUTOS HIRED NON-OWN00 AUTOS ONI •( i AUTOS ONLY UMBRELLALIAB 1 pCcup GENERAL AGGREGATE S ,000,000 PRODUCTS- COMP!OP AGO 5 0 tL U V.1,£1( --. [Ea Accesvn: BODILY INJURY (Per Peron) 001)ILY INJURY (Per axldon). EXCESS LIAR CLAIMS -MADE DED RETENTION0 WORKERS COMPENSATION ANO EMPLOYERS' OAe1LITY ANYPROPRIETORIPARTNEWEXECUTIVE OFFICERIMEMBEREXCLUOEDT Mandatory In NH) Ifyc:.describe Under L _DESCRIPTION OP OPERATIONS below VON EACH OCCURRENCE I. AGGREGATE .. NIA SrATLITE '.. ACH ACCIDENT IS .ASE' EA EMPLOYEE. S E.I OISEESE POLICY L EMIT I DESCRIPTION OF OPEP.AT!ONS O LOCATIONS I VEHICLES ;ACORN 101, Additional Remark: SO:edule, may De a,uch d If mom space IS required! Snowmobile Club and Trail Liability Insurance, including liability coverage for (2) groomers 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. Premise liability coverage is Excluded on this policy CERTIFICATE HOLDER CANCELLATION ACORD 25 (2016/03) _L SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 01OREZED REPRESENTATIVE / t G ©1988.2015 ACORD CORPORATION. All rights reserved. - The ACORD name and logo are registered marks of ACORD .uogsslauad s;l q}In+.ous `saryedoid osI to le1ta{ew pa}y6uddoo sapnfouj (a-001,09LS° suoge.epac eq; Lt! UMoys aauemsul to sllwll algeogdde ay} aseaJOul jou Heys ;uawasJopua sly; 'ssal sl JsAegONM :suope1el0a0 ayl ul uMogS aoue nsul to s;lwn algeolldde eq; Japun algel!end `i 40 auawaa46e Jo ;paw:a ay; Aq paJlnbaa °p :eoueinsui40 lunowe au} sl pansui seuonppe ayl io lleyaq uo Aed !Am am }sow ay} 'luawaai6e J0 paw.= e Aq pannb a sl paJnsul leuol}jppe 9141 0} papinoJd 56aJanoo dE :23uEJnsul b0 S4gW!1 —111 uo?haS o} pappe sl 6ulwollo4 ayl 'spansul leuogp -pe asay; o} pap!oge aoue!nsu! ayl o} loadsaJ 1Pm 'pans -ul leuol;ppe aril to uolss!wo Jo loe Aue 0} anp lou pue'noA yllrn dlysuogelai sli to any!A Aq Alalos pains -uo leuoglfppe e4} uo pasodw! sl 1e41 Alllge1l sueew ;uawasJopua slg4 w pasn se „Angell snoue0J\„ ';onpuoo inoA Jo Ansa pang pue oljloads e s; leyl ,A;lpgeli snoueoin„ s,peJnsuI leuog.lppe 9114 0l Alalos pagwli sl paJnsul leuol;ppe au} o} papioge 96849A00 ayl '5501 9144.;0 asneo 6ugnquluoo e Jo alos 0144 Jaylayrn `alnpayoS 0143 ul uMogs paJnsul leuol;lppe ay} to ;onpuooslw in)l@m .20 'Aq UOISSIwo JO loe Aue WOJj 5UM0.9a.2 „AJn[ -u! 6ulsq.anpe pue leuosJad„ Jo ,e6ewep AljedoJd„ ',AJnfuI Aupoq, hue 041Sldde jou scop aoueJnsuI 51141 ;mel Aq paglwJed;ualxa ay} of swede kuo paJnsul leuopIppe yons of pepnoge aouewnsul au; 'JanCMOH •noA of pa}ual Jo Aq paurno saslwaJd inoA y;IM uon0auuoo ul .10 :suoq?Jedo 6ulo6uo inoA ao aouewJolied ay} ui 1 :lleyaq inoA uo 6ulloe as0yl l0 suols O -slwo Jo sloe awn SO0ISS41010 sloe JnoA Aq 'alo1M ul 'pesneo „funful 6uls!peApe pue leuosJad„ Jo „a6e -wep Apadoid„ `„&Jn[w Alpoq„ Jo; /wipe!! of loadsa q4!M Akio;nq `ainpay0S ay; w UMo1s (s)uol}eziue6Jo Jo (s)uosJed ay; paJnsul leuolllppe ue se apnlo -ul al papuawe s1 paJnsul int sl 04AA — H uoc;oaS suogeJeIoaQ ay; u'i uM011s eq Aim 'anoge um lou dl 'ainpagog 54111 alaldwoo of pe nbei uane1JJcjul WINO 30VSf1 lIvaL 2118OWEVIONS 21Od ONvl 3O 3S1-1 IOd • S243NMOONV1 IIVdI 031VNOIS30 81110 311801NMONS ONV NOI1'IOOSSV 31180WMONS 317,118 11V :(s)uogezpue610 s0 is)uasJed pa.onsul leuo^3IPPV aw2N a-Ir:mos WLiOd 3 N Er\03 A1fif8V111VL13N301VI3131NN103 :6ulMopol 0144 Japun pepinoJd aouCJnsul sayipow }uawasJopua sly -L Alfli9‘1il SfOfNOIA NOILV'ZINVE»IO U , NOSti3d CI3IVNO S3O — O2Hd1SNi 1YNOtl9 O Allf{32HV011 COV31:1 9191131e3 °A0i10d 3141 S39NVH3 iNg1A13S}OCIN3 SIH; AillifillVil 1VH3N3O1V'i3ellaI IMPJ03 CLUB NAME: SNO HAWKS. INC_ LANDOWNERS AS ADDITIONAL INSURED FOR CLUB CONTRACTED TRAIL USAGE ONLY City ofianesville Iowa 227 Main Street Janesville, IA 50647 The State of Iowa. & All of its politica! Subdivisions 'Wallace State Office Building Des Moines, IA 50319 Five Star Snow TrailsAssociation 5912 Aster Lane Waterloo, IA 50701 Pagel oft