2021 APPLICATION FORMProject Funding for Local Initiatives (LI)

Construction Projects

www.PalmBeachTPA.org 1

Project Title

Applicant

WHAT DO YOU WANT TO BUILD? In no more than 3 sentences, provide a general description of the project and what it will accomplish.

WHO OWNS THE RIGHT-OF-WAY? Check whether the applicant and/or another agency owns the right-of-way where the project will be built. Resolution of support from facility owner clearly indicating that the project may be constructed asproposed is a required attachment (see submittal checklist).

☐ Applicant ☐ Other Entities __________________________________Requires resolution letter from owner allowing project to be built.

WHO IS DOING WHAT? Check the applicable boxes. All projects on state highways must be administered and constructed by FDOT. For projects on local roadways (county or city), the applicant may administer the project or ask FDOT to administer the project on their behalf. Locally administered projects require a Local Agency Program (LAP) agreement to administer Federal Aid projects in accordance with FDOT’s Local Agency Program Manual (topic no. 525 010 300).

Administered by: Funded by:

Design (PE) ☐ Applicant (required if locally administered)☐ TPA (if FDOT administered)

Construction (CST)

☐ Applicant or consultant(1)(2)

☐ FDOT (requires prior approval)

☐ Applicant or consultant (1)

☐ FDOT (requires prior approval)☐ Other: _______________

Const Eng & Inspect (CEI) ☐ Applicant or consultant (1)(2)

☐ FDOT (requires prior approval)

☐ Applicant

☐ TPA

☐ Applicant (if locally administered project)☐ TPA (if FDOT administered project)

(1) FDOT pre-qualified consultants must be used on all design and CEI work for critical projects (a project is considered criticalwhen it is on the State Highway System (SHS), features a major structure, and/or has a budget greater than $10 million)(2) Design consultant and CEI consultant shall not be the same.

www.PalmBeachTPA.org 2

APPLICANT CONTACT INFORMATION

Contact Person

Title

Email

Phone Number

Address

PROJECT LOCATION

Road Name

Road Number

Project Limit Begin

Project Limit End

QUALIFYING ACTIVITIES FOR FUNDING

Check the box that represents the majority of the work the proposed project will address. Eligible activities must be consistent with details described under 23 U.S.C. 133(b).

Complete Street projects - Including Lane Narrowing, Lane Elimination, Bicycle Facilities, Pedestrian Facilities, Transit Infrastructure, Intelligent Transportation Systems (ITS), Median Modifications, Signing and lighting, Turn Lanes, Traffic Signals, Striping and Marking.

Transit capital - purchases of vehicles, shelters, park-and-ride facilities. Can also pay up to 50% of a 3-year turn-key contract for new transit service (e.g. trolley service)

Non-motorized infrastructure - Separated, Buffered and/or designated bike lanes, Sidewalks, Shared-use paths, Street lighting

Freight efficiency - Airport or seaport off-site capacity improvements, Railway capacity improvements, Truck movement improvements.

Other eligible activities not specified above

www.PalmBeachTPA.org 3

PROJECT TYPICAL SECTION INFORMATION

Complete the following information for existing & proposed features, dimensions, & right of way lines. The typical section information provides an understanding of the spacing requirement differences between the existing facilities and the proposed facilities.

EXISTING PROPOSED

RIGHT-OF-WAY WIDTH Project must fit within current ROW, acquisition is not permitted

PEDESTRIAN OR MULTIUSE FACILITIES

Length (miles) for one direction. Do not count both sides of roadway. Width on North or West side (feet)*

Width on South or East side (feet)*

BICYCLE FACILITIES

Bike Lane Length (feet) for one direction. Do not count both sides of roadway.Width on North or West side (feet)* (not Including Buffer Width)

Proposed improvements requires:

MOTORIZED VEHICLE FACILITIES

Number of Through Travel Lanes

Typical Through Lane Width (feet)

Total Width* (No. Travel Lanes x Lane Width)

Posted Speed Limit

Design Speed (if known)

MEDIAN/SWALE/CURBMedian/Center Turning Lane Width (feet)*

Swale Width (feet)*

*TOTAL WIDTH OF ALL COMPONENTS (Add all rows with red for total width) Must

fit within existing right-of-way.

RIGHT-OF-WAY OWNERSHIP DOCUMENTATION

Describe the project's existing right-of-way ownerships. This description shall identify when the right-of-way was acquired

and how ownership is documented (i.e. plats, deeds, prescriptions, certified surveys, easements). If right-of-way is an

easement, please describe the easement language. Right-of-way ownership verification documents are a required

attachment (see submittal checklist on page 9).

Width on South or East side (feet)* (not Including Buffer Width)

Buffer Width on North or West side (feet)*

Buffer Width on South or East side (feet)*

Curb Width (feet)*

SharrowsPavement widening Restriping

www.PalmBeachTPA.org 4

PROJECT SCOPE OF WORK

Access Management revisions (median modifications, impacts to driveways, etc.)

Transit Improvements

Signalization

Describe how the proposed improvements will affect the following:

ADA items (crosswalks, sidewalks, ramps, etc.) All proposed crosswalks, sidewalks, ramps, etc. comply with ADA standards YES NO

YES NO

Pedestrian and/or Roadway Lighting

Pedestrian lighting proposed Roadway lighting proposedYES NO YES NO

Landscape (with Local Funds)

Median landscape proposed Irrigation items proposed

Other landscape proposedYES NOYES NO

YES NO

Pedestrian signals proposed Existing signalization to be replaced New traffic signalization proposed

YES NOYES NOYES NO

School Zone Modifications

Queue jump possible YES NO

Upgrade existing bus bay area YES NO

Transit provider concurrence provided YES NO

Existing flashing school zone signal on state road

High emphasis cross walk at unsignalized crossingYES NOYES NO

www.PalmBeachTPA.org 5

Summarize any special characteristics of the project.

Identify any upcoming projects or projects currently underway adjacent to the proposed project.

Other specific project information that should be considered.

Drainage and/or other Permits

Utility Modifications

Sub-surface relocation is required Utility coordination is requiredYES NO YES NO

Existing closed drainage system to remain

Existing open drainage system to remain

YES NO

YES NO

YES NO Replace railroad signal equipment and gates YES NO

Railroad Crossing Modifications

Rail crossing within limits

Bridge Modifications

Proposed pedestrian bridge Proposed bridge widening

Additional Information

Bridge replacementYES NOYES NO

YES NO

Other Scope Items

www.PalmBeachTPA.org 6

PUBLIC INVOLVEMENT AND SUPPORT

Describe the public outreach and support for the project (i.e. petitions, written endorsements, resolutions, etc.).

Attach documentation.

Projects impacting single family residential lots will require additional documentation of public support. Additional documentation must indicate that all property owners directly affected by the improvement were notified, that at least 25 percent of the property owners showed support for the project, and that no more than 10 percent of the property owners showed lack of support.

PROJECT MAINTENANCE

Document ownership and maintenance responsibilities for the project when complete. Applicant’s Resolution of Support

and commitment to fund operations and maintenance of the project is a required attachment. See submittal checklist

on page 9).

www.PalmBeachTPA.org 7

COST ESTIMATE

The total construction amount of Local Initiatives Program funds requested per projects (infrastructure) must be in excess of $250,000 with a maximum project amount of $5,000,000.

Local Initiatives Program funds will be used to fund Construction, Construction Engineering and Inspection Activities (CEI) and FDOT in-house support activities. The applicant may also request that Local Initiative Program funds be used for project Design, Environmental Services, and Post Design Services.

Local Funds (LF) will be used for all non-participating items, contingency activities, and any costs in excess of the awarded funding (LI) allocation.

(a) Provide detailed project cost estimate using one of the following forms. Estimate shall be broken down toeligible and non-eligible project costs. Estimates are to be prepared and signed by a Professional Engineer fromthe Local Agency’s Engineering office.

a. On-System (on State Highway System) Cost Estimate Sheet

b. Off-System (not on State Highway System) Cost Estimate Sheet

Use the following links to access the basis of estimates manual as well as historical information for the project

area.

Basis of Estimates Manual

Historical Cost Information

www.PalmBeach .org 8

CERTIFICATION OF PROJECT SPONSOR

I hereby certify that the proposed project herein described is supported by (municipal, county, state or federal agency, or tribal council) and that said entity will:

1) provide any funding required in addition to the grant amount;

2) enter into a LAP and maintenance agreement with the Florida Department of Transportation;

3) have complied with the Federal Uniform Relocation Assistance and Acquisition Policies Act for any

Right of Way actions intended for this project previously performed within the project limits;

4) will comply with NEPA process prior to construction, which may involve coordination with the State

Historic and Preservation Office (SHPO); and

5) support other actions necessary to fully implement the proposed project.

I further certify that the estimated costs included herein are reasonable, and that increases in these costs could cause significant increase to the local agency required participation. I understand failure to follow through on the project once programmed in the Florida Department

Signature

Name (please type or print)

Title

Date

FOR FDOT USE ONLY

Application Complete Yes No

Project Eligible Yes No

Implementation Feasible Yes No

Indian Trail Improvement District

Burgess Hanson

Executive Director

Ryan

Polygon

I I . SUMMARY OF EXISTING CONDITIONS

25

PBC

PBC

PBC

INDIANTRAILSGROVE(PBC)

WESTLAKE

WPB

PBG

RPB

LOXAHATCHEEGROVES

WELLINGTON

GrassyWaters

Preserve

Mango

130th

168th

110th

120th

100th Ln N

Okeechobee BlvdOkeechobee Blvd

Sem

inol

e Pr

att W

hitn

ey R

d

SeminolePratt

WhitneyRd

Royal PalmBeachBlvd

Southern BlvdSouthern Blvd

Northlake Blvd Northlake Blvd

N St

ate

Road

7NState

Road7

State Road 80

State Road 80

J.W. CorbettWildlife

Management Area

GrassyWatersPreserve

County PinesSamuel

Friedland Park

SeminolePalms ParkLoxahatchee

Groves Park

Sansbury WayDistrict "K"

Property

ArdenPropertyTwenty Mile

Bend Property

SycamoreLane Park

Bob Hoefl

Kidscape Park

Downers Park

Citrus GroveBlvd Park Coconut Park

AcreageCommunity

Park

TempleBlvdPark

Nicole HornsteinEquestrian

Park

Royal PinesNatural Area

140th

Hamlin

Grapeview

Chee

tham

Hill

Avenir

Hall

44th

Hamlin

Citrus Grove

Temple

Margo

Orange

Mandarin

Banyan

180th

162nd

40th

Apache

Orange Grove

Apache

Avocado

Calamondin

180th

Mandarin

140th

Avocado

120th

Coconut

110th

Persimmon

60th 60th

TownCenter

Tangerine

40th

Key Lime

Tangerine

Valencia

Orange

PradoAlan Black

61st

Temple

70th

C-51 C-51

L Ca

nal

M-1

Can

al

L-13

M-1

Can

al

M Canal

M-2

Can

al

M Canal

L-8

L-8

L-8

60th

Orange

60th

Sycamore

Coconut

190th

Esri, HERE, Garmin, (c) OpenStreetMap contributors, and the GIS user community0 0.5 1 1.5 2 2.5 3

Miles

Non-Motorized Network & DestinationsEquestrianFacility EntranceNeighborhoodFacilityPublic SchoolEquestrianShared-Use PathBicycle NetworkSidewalks

Existing RoadRegionalSub-RegionalLocal

Proposed RoadRegionalSub-RegionalLocalCanalParkCommercialActive UnitITID

NON-MOTORIZED NETWORK & DESTINATIONS

Lion Country Safari

Photographs

Photographs

Photographs

Photographs

Photographs

Indian Trail Improvement District 140th, Temple, and Hall Multi-Use Trail and Sidewalk Expansion Project

DRAFT

DescriptionProposed 8-10-foot-wide* multi-use

trail and 5-foot-wide sidewalk expanded to an 8-foot-wide width.

(See typical section exhibits).1. 140th Avenue North (1.0 miles)

from Temple to Orange Boulevard within a 60-foot R/W.

2. Temple Boulevard (2.1 miles) from Seminole Pratt Whitney to 140th Avenue North within an 80-foot R/W.

3. Hall Boulevard (1.7 miles) from Hamlin to Key Lime Boulevard within an 80-foot-wide R/W.

Total project length (4.8 miles).*Note: 8’ wide multi-use trail along 140th

Avenue North due to constrained R/W.

Local Initiatives

8.0'EASE

MEN

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/W2% 6%

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4:1 MATCHEXISTING

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DRAFT 2/11/21

NOTE:1. ALL SIDEWALKS WITHIN PROJECT LIMITS SHALL

BE ADA COMPLIANT. ANY DEFICIENCIES OROBSTRUCTIONS SHALL BE REMEDIED WITH THISPROJECT.

2. ROOT BARRIER REQUIRED FOR ALL TREESADJACENT TO SIDEWALK.

3. CANAL CULVERTS NOT INCLUDED IN THISPROJECT'S COST ESTIMATE.

4. DRIVEWAY CULVERT ADJUSTMENTS SHALL BE INCOMPLIANCE WITH INDIAN TRAIL LATESTSTANDARDS.

5. PATTERNED PAVEMENT INCLUDED AT EACHPAVED INTERSECTION CROSSWALK.

6. BIO-SWALE PODS WITH SPLIT-RAIL FENCINGINCLUDED AT EACH PAVED INTERSECTION.

7. STORM-WATER PIPE AND INLETS NECESSARYFOR DRAINAGE ON 140TH AVENUE NORTH.

80' RIGHT OF WAYTYPICAL SECTION

TEMPLE BOULEVARD(east-west) from Seminole Pratt

Whitney Road to 140th Avenue North(2.1 Miles)

5.0'

EASE

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6.0'

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DRAFT 2/11/21

NOTE:1. ALL SIDEWALKS WITHIN PROJECT LIMITS SHALL

BE ADA COMPLIANT. ANY DEFICIENCIES OROBSTRUCTIONS SHALL BE REMEDIED WITH THISPROJECT.

2. ROOT BARRIER REQUIRED FOR ALL TREESADJACENT TO SIDEWALK.

3. CANAL CULVERTS NOT INCLUDED IN THISPROJECT'S COST ESTIMATE.

4. DRIVEWAY CULVERT ADJUSTMENTS SHALL BE INCOMPLIANCE WITH INDIAN TRAIL LATESTSTANDARDS.

5. PATTERNED PAVEMENT INCLUDED AT EACHPAVED INTERSECTION CROSSWALK.

6. BIO-SWALE PODS WITH SPLIT-RAIL FENCINGINCLUDED AT EACH PAVED INTERSECTION.

5.0'

EASE

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23.0'15.0'

6"6"

6.0'

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OFSHEET

JOB No.:

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657

Joseph W. Capra301 N.W. Flagler Ave.Stuart, Florida 34994

P.E. No. 37638

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DRAFT 2/11/21

80' RIGHT OF WAYTYPICAL SECTION

HALL BOULEVARD(north-south) from Hamlin to

Key Lime Boulevard (1.7 Miles)NOTE:1. ALL SIDEWALKS WITHIN PROJECT LIMITS SHALL

BE ADA COMPLIANT. ANY DEFICIENCIES OROBSTRUCTIONS SHALL BE REMEDIED WITH THISPROJECT.

2. ROOT BARRIER REQUIRED FOR ALL TREESADJACENT TO SIDEWALK.

3. CANAL CULVERTS NOT INCLUDED IN THISPROJECT'S COST ESTIMATE.

4. DRIVEWAY CULVERT ADJUSTMENTS SHALL BE INCOMPLIANCE WITH INDIAN TRAIL LATESTSTANDARDS.

5. PATTERNED PAVEMENT INCLUDED AT EACHPAVED INTERSECTION CROSSWALK.

6. BIO-SWALE PODS WITH SPLIT-RAIL FENCINGINCLUDED AT EACH PAVED INTERSECTION.

Pay Item Number* Pay Item Description* Quantity Unit

Engineer's Unit

Cost Engineer's Subtotal Cost Quantity Unit

Engineer's Unit

Cost Engineer's Subtotal Cost

Total

Quantity Total Engineer's Cost

101-1 Mobilization (Includes root barrier) 1 LS 160,000.00$ 160,000.00$ -$ 1 $ 160,000.00

102-1 Maintenance of Traffic 260 DA 582.30$ 151,398.00$ -$ 260 $ 151,398.00

104-1 Erosion Control 10250 LF 3.50$ 35,875.00$ -$ 10250 $ 35,875.00

107-1 Litter Removal -$ 33.3 AC 16.42$ 546.79$ 33.3 $ 546.79

107-2 Mowing -$ 48.3 AC 36.99$ 1,786.62$ 48.3 $ 1,786.62

110-1-1 Clearing & Grubbing 12.3 AC 10,102.19$ 124,256.94$ -$ 12.3 $ 124,256.94

120-6 Embankment (regrade to swale-line (both sides)) 10700 CY 18.20$ 194,740.00$ -$ 10700 $ 194,740.00

285-701 Optional Base Group 1 (compacted surface) 30000 SY 4.34$ 130,200.00$ 30000 $ 130,200.00

334-1-13 Superpave traffic C (Includes Micro-resurfacing) (asphalt sidewalk) 680 TN 110.81$ 75,350.80$ 630 TN 110.81$ 69,810.30$ 1310 $ 145,161.10

425-15-23 Ditch bottom inlets, Type C 18 EA 5,500.00$ 99,000.00$ -$ 18 $ 99,000.00

430-175-118 Pipe Culvert, Optional Material, Round 18" 4530 LF 52.90$ 239,637.00$ -$ 4530 $ 239,637.00

522-1 Driveway adjustments (Per Indian Trail Standard Detail) 148 EA 1,050.00$ 155,400.00$ -$ 148 $ 155,400.00

523-1-3 Patterned Pavement (crosswalk markings) 900 SY 75.00$ 67,500.00$ -$ 900 $ 67,500.00

570-1-2 Sod (stabilization) 43400 SY 2.41$ 104,594.00$ -$ 43400 $ 104,594.00

527-2 Detectable warnings 470 SF 28.82$ 13,545.40$ -$ 470 $ 13,545.40

700-1-11 Single-Post Sign, F&I, Less than 12 SF 42 EA 336.85$ 14,147.70$ -$ 42 $ 14,147.70

711-11-123 Thermoplastic, Std, Crosswalk, White, Solid, 12" 1600 LF 2.09$ 3,344.00$ -$ 1600 $ 3,344.00

711-11-999 Thermoplastic, Pavement Markings 12 EA 500.00$ 6,000.00$ -$ 12 $ 6,000.00

900-A Bioswale pods (Incl. storm pipe, bedding stone, split-rail fence and grass) 34 EA 8,500.00$ 289,000.00$ -$ 34 $ 289,000.00

1199-A Advance Warning Pedestrian Crossing Blinker-Sign F&I 12 EA 2,800.00$ 33,600.00$ -$ 12 $ 33,600.00

1644-A Utility adjustments (water meters, valves deflections and relocates) -$ 1 LS 20,000.00$ 20,000.00$ 1 $ 20,000.00

1,897,588.84$ 92,143.70$ Subtotal $ 1,989,732.54

1 LS $5,000 5,000.00$

1 LS $2,000 2,000.00$

1 LS $5,000 5,000.00$

1 LS $2,000 2,000.00$

1 LS 10% 198,973.25$

1 LS 10% 198,973.25$

0 LS 10% -$

1 LS 12% 238,767.90$ 1 LS 3% 59,691.98$

1,971,280.81$ 728,858.12$ 2,700,138.93$

*Projects on the State Highway System and Critical Projects SHALL utilize FDOT pay items numbers and descriptions. Prepared by: PE Number: 88512

Non-participating items: Dylan O'Berry, PE ______________________________________________ 1/28/2021

- Mowing & Litter removal Name: Signature: Date:

- Engineering work; Optional services; Survey; Video inspection; MOT plans preparation; As-builts/record drawings

- Utility work -- this includes, but is not limited to: valve adjustments, utility relocations, FPL power pole relocations, AT&T directional bore, etc… Reviewed by: - Contingency

Other elements may be non-participating; the ones listed above are the commonly used pay items that are non-participating. Joe Capra, PE ______________________________________________ 1/28/2021

- Existing 5-foot wide asphalt sidewalk. All sidewalk deficiencies and obstructions shall be removed and replaced. Name: Signature: Date:

If you have any questions regarding an eligible or non-participating item, please contact District Four Local Program Unit. Approved by (Agency Responsible Charge):

Thank you! ________________________________ ________________________________________________________________

Total Construction Cost

Estimate

LOCAL FUNDS FOR DESIGN Local Agency Design Work is not a FHWA Participating Item

CONTINGENCY (Phase 58) (REQUIRED) Contingency is not a FHWA Participating Item

TRANSIT RELATED PROJECTS (10% FTA ADMINISTRATIVE FEE) Administrative Fee is not a FHWA Participating Item

CONSTRUCTION ENGINEERING & INSPECTION ACTIVITIES (CEI) (Phase 68)FDOT OVERSIGHT CEI (3% OF TOTAL CONSTRUCTION COST ESTIMATE) (Phase 62) (REQUIRED) FDOT In-House Support must be included as an FHWA Participating

Subtotal FHWA

Participating

Subtotal FHWA Non-

Participating

Funds for Construction (Phase 58) Local Funds for Construction (Phase 58)

FDOT IN-HOUSE DESIGN SUPPORT (Phase 31) (REQUIRED)

FDOT In-House Support must be included as an FHWA Participating

Item

ADDITONAL FDOT IN-HOUSE DESIGN SUPPORT FOR CRITICAL PROJECTS

FDOT IN-HOUSE CONSTRUCTION SUPPORT (Phase 61) (REQUIRED)

ADDITONAL FDOT IN-HOUSE CONSTRUCTION SUPPORT FOR CRITICAL PROJECTS

ENGINEERS COST ESTIMATE

Project Description: INDIAN TRAIL IMPROVEMENT DISTRICT 140TH, TEMPLE AND HALL MULTI-USE TRAIL AND SIDEWALK EXPANSION PROJECT (4.8 MILES)

FM#100000-2-12-21

FHWA Participating FHWA non-participating (Local funds)

LOCAL INITIATIVES FUNDS

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