HomeMy WebLinkAboutItem 16 - Council Reading File - Madonna Road BridgeExhibit 6‐A
LAPG, Application/Scope Definition Form
Local Assistance Program Guidelines EXHIBIT 6-A
HBRRP Application/Scope Definition Form
Page 6-43
LPP 01-12 December 20, 2001
EXHIBIT 6-A HBRRP APPLICATION/SCOPE DEFINITION FORM
See Section 6.6, Chapter 6 of the LAPG for information about this form.
This form shall replace Exhibit 7-D, “Major Structure Data,” from Chapter 7, “Field
Review,” of the LAPM. Wherever the LAPM requires Exhibit 7-D for other programs, Exhibit
6-A may be substituted. Bridge projects funded entirely through other programs should continue to
use Exhibit 7-D.
(One bridge per application, separate applications are required for multiple bridges at same
location. Multiple bridges may be combined into one federal aid project later.)
State Bridge No. 49C0372 Local Bridge No.
Project Number (Caltrans to provide project number for new projects)
Responsible Agency City of San Luis Obispo
Caltrans District 05
County San Luis Obispo
Project Manager David Athey
Title Supervising Civil Engineer
Phone (805) 781-7200 Fax (805) 781-7198
E Mail DAthey@slocity.org
Project Location Madonna Road over Perfumo Creek, East of Oceanaire Dr.
Project Limits 200' NE of the Bridge to 200' SW of the Bridge
Type of Work Replacement
Work Description Replace the Functionally Obsolete (FO) 4-lane Triple Box Culvert with a 6-
Lane Multicell PC RC Box Culvert
HBRRP Category:
Rehabilitation Scour Countermeasure
Replacement Replacement Due to Flood Control Project
Painting New Bridge to Replace Ferry Service
Bridge/Railing/Approach Barrier Replacement Historic Bridge
Low Water Crossing Replacement High Cost Bridge
Minimal Application: Only questions 1,2,3, 4, cost data and signoff will be completed. Other
information will be submitted at a later time after PE has been federally authorized to scope the
project. See Section 6.6.2 “Minimum Application Requirements” for additional information.
EXHIBIT 6-A Local Assistance Program Guidelines
HBRRP Application/Scope Definition Form
Page 6-44
December 20, 2001 LPP 01-12
The field review process enables the proper scoping of projects. Some field reviews are mandatory,
most are optional. Field reviews are critically important to identify difficult environmental, Right
of Way, and bridge type selection issues early in the project development phase. Please see
Chapter 7 of the LAPM for further discussion.
1. Do you request that Caltrans initiate a field review? Yes No
2. Do you need help with consultant selection/oversight? Yes No
3. Do you need help with the federal process? Yes No
4. Caltrans engineers are available to provide an optional cursory review of the PS&E. The
review looks at constructability, standard details and specifications, foundation/hydraulic
design, and HBRRP funding eligibility. Do you request Caltrans perform a cursory PS&E
review for this project? (If yes, please also request a field review.) Yes No
Federal Congressional District(s) 24
State Senate District(s) 17
State Assembly District(s) 35
Preliminary Engineering by: Local Agency Staff Consultant Other…
Design by: Local Agency Staff Consultant Other…
Foundation Investigation by: Local Agency Staff Consultant Other…
Hydrology Study by: Local Agency Staff Consultant Other…
Detour, stage construction, or close road? Stage Construction
Length of detour: 1.58 Miles
Resident Engineer for Bridge Work: Local Agency Staff Consultant Other…
Local Assistance Program Guidelines EXHIBIT 6-A
HBRRP Application/Scope Definition Form
Page 6-45
LPP 01-12 December 20, 2001
For painting & scour scopes of work, skip this page.
NBI data is from the Bridge Inspections Report (SI&A sheet)
Contact the DLAE/SLA for assistance, if needed
Date Constructed (NBI Item 27): 1958 Historical Bridge Category (NBI Item 37) 5
Structure Data Existing Proposed
Minimum
AASHTO
Standards
Structure type Grade Top RC
double box culvert
widened with RC
single box culvert
Multicell PC RC
Box Culvert
Structure length (specify units) 40 feet 36 feet
Spans (No. and length) 2 @ 11 ft 1 @ 15.5
ft
3 @ 12'
Curb to Curb width
(See NBI Item 51 definition)
80 ft 84 ft 84 ft
Number of lanes 4 6
Lane widths 11 ft 11 ft 11 ft
Shoulder widths 12 ft Lt 12 ft Rt 8 ft Lt 8 ft Rt 4.4.2 Width of
Shoulders: 6-ft to
8-ft shoulder width
is preferrable
Bike lanes
(identify only if not included in
the shoulder dimensions)
0 ft Lt 0 ft Rt 0 ft Lt 0 ft Rt
Included in the
shoulder dimension
Sidewalks/separated bikeways 9 ft Lt 9 ft Rt 6 ft Lt 6 ft Rt 4.17.1 Sidewalks:
6-ft when adjacent
to the curb
Approach roadway width
(traveled way + paved shoulders,
tapered approaches should be
measured at the touchdown
points not the abutments)
80 ft 84 ft 84 ft
EXHIBIT 6-A Local Assistance Program Guidelines
HBRRP Application/Scope Definition Form
Page 6-46
December 20, 2001 LPP 01-12
Approach road length
(from each abutment)
200 ft abt1
200 ft abt2
200 ft abt1
200 ft abt2
Total bridge deck width 98 ft 98 ft
Local Assistance Program Guidelines EXHIBIT 6-A
HBRRP Application/Scope Definition Form
Page 6-47
LPP 01-12 December 20, 2001
Summary of Major Deficiencies of Existing Bridge (See Section 6.12 for information)
(Contact the DLAE/SLA for assistance, if needed)
Data is from SI&A Sheet (Last page of Bridge Inspection Report)
Sufficiency Rating (SR) = 54.1 Status SD FO Blank
Description of
Data Item NBI Data Item Deficient Criteria Results What are the Deficiencies?
Deck Item 58 = N ≤ 4
is problem
OK
NG-SD
Superstructure Item 59 = N ≤ 4
is problem
OK
NG-SD
Substructures Item 60 = N ≤ 4
is problem
OK
NG-SD
Culvert and
Retaining Walls
Item 62 = 7
≤ 4
is problem
OK
NG-SD
Structural
Condition
Item 67 = 3 ≤ 3
is problem
OK
NG
Stage-2 cracking on barrel walls
Waterway
Adequacy
Item 71 = 8
≤ 3
is problem
OK
NG
Deck
Geometry
Item 68 = 9 ≤ 3
is problem
OK
NG-FO
SD = Structurally Deficient
FO = Functionally Obsolete
Blank = Not SD or FO
NG = Not Good (Deficiency)
[Item 62 applies only if the last digits of Item 43 are coded 19.]
[Item 71 applies only if the last digit of Item 43 is coded 0, 5, 6, 7, 8, or 9.]
EXHIBIT 6-A Local Assistance Program Guidelines
HBRRP Application/Scope Definition Form
Page 6-48
December 20, 2001 LPP 01-12
Description of
Data Item NBI Data Item Deficient Criteria Results What are the Deficiencies?
Under-
clearances
Item 69 = N
≤ 3
is problem
OK
NG-FO
Approach
Roadway
Alignment
Item 72 = 8 ≤ 3
is problem
OK
NG-FO
Scour
Criticality
Item 113 = 8 ≤ 3
is problem
OK
NG
Bridge Railing Item 36A = 0 = 0
Review
OK
NG
Non-standard bridge railing;
Does not meet the Guide for the
Planning, Design, and Operation
of Pedestrian Facilities
Guardrail
Transition,
Approaches,
Guardrail Ends
Item 36B = 0
Item 36C = 0
Item 36D = 0
= 0
Review
OK
NG
No approach railing
Other deficiencies
not identified in
Bridge Inspection
Report
Discuss in detail, attach additional pages and photographs as needed to justify
HBRRP funds to correct problem:
Stormwater inlets and public service utilities encroach into the walkway on approach
to limit access
[Item 69 applies only if the last digit of Item 42 is coded 0, 1, 2, 4, 6, 7 or 8.]
Local Assistance Program Guidelines EXHIBIT 6-A
HBRRP Application/Scope Definition Form
Page 6-49
LPP 01-12 December 20, 2001
5. If this application is for rehabilitation or replacement scope, will all deficiencies be resolved by
the project? If no, please discuss below or attach discussion on separate pages to application.
Yes No Not Applicable
6. Discuss any special condition or proposed design exceptions:
7. Identify and justify “betterments” that are HBRRP participating but are not related to the major
deficiencies. Attach additional pages as needed.
8. Refer to Exhibit 6-B. Identify and justify specific items requiring Caltrans funding approval.
Attach additional pages as needed.
Proposed bridge replacement recommended due to Stage-2 cracking on the wall and throughout
barrel. Traffic volumes support the additional lanes.
EXHIBIT 6-A Local Assistance Program Guidelines
HBRRP Application/Scope Definition Form
Page 6-50
December 20, 2001 LPP 01-12
9. Other comments: (identify non-HBRRP participating work)
Estimated Construction Costs:
Exclude Contingencies, Supplementary Work, and Construction Engineering
HBRRP Participating
NOT
HBRRP Participating*
Construct Bridge $880,000.00 $0.00
Bridge Removal $190,000.00 $0.00
Slope Protection $0.00 $0.00
Channel Work $90,000.00 $0.00
Detour – Stage Construction $110,000.00 $0.00
Approach Roadway $270,000.00 $0.00
Utility Relocation $100,000.00 $0.00
Mobilization $164,000.00 $0.00
Total $1,804,000.00 $0.00
Total Cost $1,804,000.00
∗ Items that are not HBRRP participating could be participating through other federal programs.
See the LAPG for other eligibility requirements of other programs. Local agencies that are
unsure which project costs are HBRRP participating should contact the DLAE/SLA for
resolution.
Note that the total of the HBRRP participating costs should carry over into the construction line
(direct costs) on the next page.
Local Assistance Program Guidelines EXHIBIT 6-A
HBRRP Application/Scope Definition Form
Page 6-51
LPP 01-12 December 20, 2001
Summary of HBRRP Participating Costs
Please indicate the HBRRP total participating (eligible for reimbursement) costs for this project.
Based on the amounts below and the federal reimbursement rate, Caltrans will program (reserve)
the HBRRP funds needed for this project. Other federal funds (RSTP, TEA, etc.) needed for this
project should be shown in the Field Review form Exhibit 7-B from Chapter 7 of the LAPM.
Target dates represent a commitment by the local agency when the project will need HBRRP
funding. Failure to meet target dates may cause funds to be reprogrammed to other projects by
other local agencies. The reprogramming of HBRRP funds is at the discretion of Caltrans.
PE = Preliminary Engineering (Total not to exceed the greater of $75 K or 25% of CON and
consultant contract management and quality assurance not to exceed 15% of consultant costs).
R/W = Right of Way
CE = Construction Engineering (Not to exceed 15% of CON).
CON = Construction
Cont = Contingency (including supplement work) not to exceed 25% (preliminary estimate) nor 10%
of CON for final design $5 K min.
Enter CE Rate: 15%
Enter Contingency Rate: 25%
Direct Costs Indirect Costs*
HBRRP
Participating $** Target Dates
PE $451,000.00 + $0.00 = $451,000.00 2017
R/W $100,000.00 2019
CON $1,804,000.00
CE $270,600.00 $0.00
Cont $451,000.00
Subtotal $2,525,600.00 + $0.00 = $2,525,600.00 2020
Total Participating Cost $3,076,600.00
Enter Fed. Match Rate: 88.53% HBRRP Requested $2,723,714.00
* See Chapter 5, “Accounting/Invoices,” of the LAPM for approval of indirect costs.
** Participating costs exclude ineligible work items. Please review the HBRR Program Guidelines
for reimbursable scopes of work and program cost limits. Other federal funds will be shown in
the Field Review form, Exhibit 7-B, Chapter 7, “Field Review,” of the LAPM.
Exhibit 6‐B
LAPG, Special Cost Approval Checklist
Local Assistance Program Guidelines EXHIBIT 6-B
HBRRP Special Cost Approval Checklist
Page 6-53
LPP 01-12 December 20, 2001
EXHIBIT 6-B HBRRP SPECIAL COST APPROVAL CHECKLIST
The purpose of this form is to help local agencies identify project costs that require Caltrans funding
approval. Local agencies are responsible for contacting the DLAE to resolve any items requiring
Caltrans review. This form is not a substitute for reading Chapter 6 of the LAPG or the LAPM.
Local agencies are still financially accountable for meeting all the requirements of the LAPG and
the LAPM.
Project Number
State Bridge No. 49C0372 (one bridge per application) Local Bridge No.
Project Location Madonna Road over Perfumo Creek, East of Oceanaire Dr.
Chapter 6
LAPG
Section #’s Topic Status
6.2.1 – Rehab
6.2.2 - Replace
Adding Additional Lanes
(including turn lanes)
Requires Caltrans/MPO Approval
Caltrans has Approved Costs
MPO has Approved Scope in FTSIP
Not Applicable
6.2.1 – Rehab Scope is Bridge Replacement, but SR>50 Requires Caltrans Approval
Caltrans has Approved Costs
Not Applicable
6.2.4 – Rail No bridge railing work to be done, but
other safety work related to bridge is
needed.
Requires Caltrans Approval
Caltrans has Approved Costs
Not Applicable
6.2.4 – Rail
(applies to all
scopes of work)
New sidewalks to be installed where none
existed before. Please identify as
“betterment” in Exhibit 6-A.
Requires Caltrans Approval
Caltrans has Approved Costs
Not Applicable
6.2.1 – Rehab
6.2.2 – Replace
6.2.10 – Historic
6.3 – Standards
Rehabilitation/Replacement will not
address all major bridge deficiencies
Requires Caltrans Approval
Caltrans has Approved Costs
Not Applicable
6.5.11 – Replace “Replaced” bridges to remain in place.
Applies to work beyond specified examples
in Section 6.5.12
Requires Caltrans Approval
Caltrans has Approved Costs
Not Applicable
Exhibit
Exhibit of Vicinity Map
Project Location/Vicinity Map
San Luis Obispo, CA
Project Site
N
Not to Scale
Exhibit
General Plan & Project Limits
MADONNA ROADBRIDGE REPLACEMENT PROJECTSAN LUIS OBISPO COUNTYBRIDGE NO. 49C0372
MADONNA ROADBRIDGE REPLACEMENT PROJECTSAN LUIS OBISPO COUNTYBRIDGE NO. 49C0372
MADONNA ROADBRIDGE REPLACEMENT PROJECTSAN LUIS OBISPO COUNTYBRIDGE NO. 49C0372
Exhibit
Photographs
Exhibit 7‐B
LAPM, Field Review Form
Local Assistance Procedures Manual EXHIBIT 7-B
Field Review Form
Page 1 of 4
January 2016
EXHIBIT 7-B FIELD REVIEW FORM
Local Agency ______________________________ Field Review Date __________________
Project Number ______________________________ Locator
(Dst/Co/Rte/PM/Agncy)
__________________
Project Name ______________________________ Bridge No.(s) __________________
1. PROJECT LIMITS (see attached list for various locations) _____________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________ Net Length ______________ (mile)
2. WORK DESCRIPTION _____________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
ITS project or ITS element: Yes No
If yes, choose: High-Risk (formerly “Major”) ITS
, Low-Risk (formerly “Minor”) ITS
, Exempt ITS
3. PROGRAMMING DATA
FTIP (MPO/RTPA)
______________
FY
______
Page ____
Amendment No. __________ FTIP PPNO _______ FHWA/FTA Approval Date ___________
Federal Funds $________________ Phases PE ______ R/W _______ Const ____
Air Basin: _________________________ (CMAQ only)
4. FUNCTIONAL CLASSIFICATION:
On the Federal-aid System
Principal Arterial –
Freeway or Expressway
Other Principal Arterial
Minor Arterial
Off the Federal-aid System
Rural Minor Collector
Local
Major Collector
Urban Minor Collector
5. STEWARDSHIP CATEGORY
High Profile (Stewardship): Yes No
Delegated (Stewardship): Yes No (a) DLAE oversight: Yes __ No __
(b) District Construction Yes __No __
ITS High-Risk project or element requiring FHWA oversight per stewardship: Yes __ No __
6. CALTRANS ENCROACHMENT PERMIT Is it required? Yes _____ No _____
7. COST ESTIMATE BREAKDOWN $1,000’s Fed. Participation
(Including Structures)
PE Environmental Process
Yes ____ No ____
Design
Yes ____ No ____
ITS System Manager or Integrator
Yes ____ No ____
City of San Luis Obispo
05/SLO/Madonna Rd.
Madonna Rd. over Perfumo Creek 49C0372
From the intersection of Oceanaire Dr. and Madonna Rd., approx. 200' W of the Bridge to approx. 200' E of the Bridge.
0.01
Replace the Functionally Obsolete (FO) 4-lane Grade Top Double Box Culvert with a 6-Lane Multicell PC RC Box Culvert.
135.30
315.70
N/A
EXHIBIT 7-B Local Assistance Procedures Manual
Field Review Form
Page 2 of 4
January 2016
CONST Const. Contract
Yes ____ No ____
Const. Engineering
Yes ____ No ____
R/W Preliminary R/W Work
Yes ____ No ____
Acquisition: Yes ____ No ____
(No. of Parcels ____ )
Yes ____ No ____
(Easements ____ )
Yes ____ No ____
(Right of Entry ____ )
Yes ____ No ____
RAP (No. Families )
Yes ____ No ____
RAP (No. Bus. ____ )
Yes ____ No ____
Utilities (Exclude if included in
contract items)
Yes ____ No ____
TOTAL COST $
7a. Value Engineering Analysis Required? Yes _____ No _____
(Yes, if total project costs are
$50M or more on the NHS, or
$40M or more for bridges on
the NHS)
8. PROPOSED FUNDING
Total Cost Cost Share
Grand Total $ ____________
Federal Program #1_________ $ ____________ Fed. $ _________ Reimb. Ratio _________
(Name/App. Code) #2_________ $ ____________ Fed. $ _________ Reimb. Ratio _________
Matching Funds Breakdown Local:
.
$
$ _________ _____%
State: $ _________ _____%
Other: $ _________ _____%
State Highway Funds? Yes _____ Source __________________________ No _____
State CMAQ/RSTP Match Eligible Yes _______ No ______ Partial _____
Is the Project Underfunded? (Fed $ < Allowed Reimb.) Yes ______ No _____
9. PROJECT ADMINISTRATION
Agency Consultant State
PE Environ Process
______________ ___________
Design
______________ ___________
System Man./Integ. ______________ ___________
R/W All Work
______________ ___________
2155.00
270.60
45.00
2 55.00
100.00
3076.6
3,076,600
HBP 3,076,600 2,723,714 88.53
352,886 11.47
Yes Yes
Yes Yes
Yes
Yes Yes
Local Assistance Procedures Manual EXHIBIT 7-B
Field Review Form
Page 3 of 4
January 2016
CONST ENGR Contract
______________ ___________
CONSTRUCTION Contract
______________ ___________
MAINTENANCE
______________ ___________
___________
Will Caltrans be requested to review PS&E? Yes ______ No _____
10. SCHEDULES: PROPOSED ADVERTISEMENT DATE _________________________________________
Other critical dates: __________________________________________________________________
______________________________________________________________________________________
11. PROJECT MANAGER’S CONCURRENCE
Local Entity
Representative: _________________________________________ Date: ___________
Signature & Title: _________________________________________ Phone No. ___________
Is field review required? Yes ______ No ______
Caltrans (District)
Representative: _______________________________________ Date: ___________
(if attended Field Review)
Signature & Title:
FHWA Representative:
(if attended Field Review)
Signature & Title:
________________________________________________
_______________________________________
________________________________________________
Date: ___________
12. LIST OF ATTACHMENTS (Include all appropriate attachments if field review is required. See the “[ ]”
notation for minimum required attachments for non-NHS projects)
_____ Field Review Attendance Roster or Contacts Roster
_____
_____
Vicinity Map (Required for Construction Type Projects)
IF APPLICABLE ( Complete as required depending on type of work involved)
_____ Roadway Data Sheets [Req’d for Roadway projects]
_____
_____
Typical Roadway Geometric Section(s) [Req’d for Roadway projects]
_____
Major Structure Data Sheet [Req’d for HBP] _____ Signal Warrants
_____ Railroad Grade Crossing Data Sheet _____ Collision Diagram
Yes Yes
Yes Yes
Yes
2020
David Athey
(805) 781-7200
EXHIBIT 7-B Local Assistance Procedures Manual
Field Review Form
Page 4 of 4
January 2016
_____ Sketch of Each Proposed Alternate Improvement _____ CMAQ/RSTP State STIP Match
_____ TE Application Document _____ Systems Engineering Review Form (SERF)
_____ Existing federal, state, and local ADA deficiencies
not included on other Attachments
_____ Req’d for High-Risk (formerly “Major”) and
Low-Risk (formerly “Minor”) ITS projects
13. DLAE FIELD REVIEW NOTES:
A. MINUTES OF FIELD REVIEWS
B. ISSUES OR UNUSUAL ASPECTS OF PROJECT
Distribution: Original with attachments – Local Agency
Copy with attachments (2 copies if HBP) – DLAE
Exhibit 7‐C
LAPM, Roadway Data
Local Assistance Procedures Manual EXHIBIT 7-C
Roadway Data
Page 7-15
LPP 11-05 December 12, 2011
ROADWAY DATA
1. TRAFFIC DATA
Current ADT ____ Year 20 __ Future ADT ______ Year 20___ DHV ____ Trucks __%
Terrain (Check One)____ Flat _____ Rolling ____ Mountainous
Design Speed ____________
Proposed Speed Zone ____ Yes mph ___________ No
2. GEOMETRIC INFORMATION
ROADWAY SECTION
Thru Traffic Lanes Shoulders
Facility
Year
Constr.
Min.
Curve
Radius
No. of
Lanes
Total
Width Type
Each Width
Lt/Rt Type
Median
Width
Exist.
Prop.
Min. Stds. selected:
AASHTO____
3R ____
Local ____
N/E Contig. Sect.
S/W Contig Sect.
Remarks (If design standard exception is being sought, cite standard and explain fully how it varies):
_________________________________________________________________________________
_________________________________________________________________________________
3. DEFICIENCIES OF EXISTING FACILITY (Mark appropriate one(s))
_____ Pavement Surface ______ Drainage
_____ Alignment ______ Bridge
_____ Crossfall ______ Safety (Attach collision diagram or other documentation)
_____ Pavement Structure ______
_____
Federal Americans w/ Disabilities Act (ADA), State or Local
accessibility requirements
Other (describe below)
Remarks _________________________________________________________________________
_________________________________________________________________________________
4. TRAFFIC
SIGNALS
____Yes ___New (attach warrants)___Modified _____No
5. MAJOR STRUCTURES Structure No.(s) _____________________ (attach structure data sheet)
_____________________
6. OTHER TRANSPORTATION FACILITIES (Name)
_______ None
_______ Railroad _______________________________________ (attach railroad data sheet)
_______ Airports _______________________________________ (attach airport data sheet)
_______ Transit _______________________________________
_______
T
Bicycle
_______________________________________
_______________________________________
26,985 08 3430,912 3
50 mph
45
1958 4 80 ft AC 12 ft AC 0 ft
2020 6 94 ft AC 8 ft AC 2 ft
AC946 AC8
49C0372
EXHIBIT 7-C Local Assistance Procedures Manual
Roadway Data
Page 7-16
July 21, 2006 LPP 06-03
7. AGENCIES AFFECTED
Utilities [mark appropriate one(s)] _______ Telephone ________ Electrical ________ Gas
_______ Water ________ Irrigation
_______ Other ________ Sanitary
Major Utility
Adjustment:
_____________________________________________________________________
_____________________________________________________________________
High Risk Facilities: _____________________________________________________________________
_____________________________________________________________________
Other: _____________________________________________________________________
_____________________________________________________________________
Remarks: _____________________________________________________________________
_____________________________________________________________________
Relocation of overhead communication and electrical lines and relocation of underground
sanitary sewer, domestic water, fire water, storm drain and communication.
Exhibit 7‐D
LAPM, Major Structure Data
Local Assistance Procedures Manual Exhibit 7-D
Major Structure Data
Page 1 of 2
July 2016
EXHIBIT 7-D MAJOR STRUCTURE DATA
(Attach a separate sheet for each structure)
Project Number
Bridge Name (facility crossed)
State Br.No. Date Constructed Historical Bridge Inv. Category
Road Name Location
STRUCTURE DATA
Existing Proposed
Minimum ASHTO
Standards
Structure Type:
Structure Length:
Spans (No. & Length):
Clear Width (curb to curb):
Shoulder Width: Lt Rt Lt Rt Lt Rt
Sidewalk or bikeway width: Lt Rt Lt Lt Lt Rt
Total Br. Width:
Total Appr. Rdwy. Width:
1. Preliminary Engineering by:
2. Design by:
3. Foundation Investigation by:
4. Hydrology Study by:
Detour, Stage construction, or Close Road:
Length of Detour:
Resident Engineer for Bridge Work: Agency Consultant (On Retainer as City/County Engineer)
Responsible Local Official:
Discuss any special conditions; for example, federal ADA, state or local accessibility requirements, or
proposed design exceptions:
ESTIMATED STRUCTURE AND RELATED COSTS Federally
Participating?
Bridge Cost: Yes No
Construct Bridge:
Bridge Removal:
Slope Protection:
Channel Work:
Perfumo Creek
49C0372 1958 5
Madonna Rd. East of Oceanaire Dr.
Grade Top RC box culvert
40 ft
2 @ 11 ft ;1 @ 15.5 ft
Multicell PC RCB
36 ft
3@12ft
84 ft 84 ft80 ft
12 ft 12 ft 8 ft 8 ft 8 ft 8 ft
9ft 6ft 6ft 6ft9ft
98 ft
80 ft
6ft
98 ft
84 ft
98 ft
84 ft
City + Consultant
Consultant
Consultant
Consultant
Stage Construction
1.58 Miles
$ 880,000
$ 190,000
$0.00
$ 90,000
✔✔
✔
✔
✔
✔
Local Assistance Procedures Manual Exhibit 7-D
Major Structure Data
Page 1 of 2
July 2016
Detour- Stage Construction:
Approach Roadway:
Preliminary Engineering:
Construction Engineering:
Right of Way Costs:
Utility Relocation:
Mobilization:
Total:
-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------
Type of HBP funds; Check one: Seismic/Voluntary Painting (88.53%)
(Major type if more than one) (88.53% Fed. Share) Painting (80%)
Rehabilitation (80%) Special (80%)
Replacement (80%) Low Water Xing (80%)
Railing (88.53%)
-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------
Summarize HBP funded costs of above estimate
(HBP Federal-aid + local match for HBP only):
Prelim. Engr.: $
Right of Way: $
Construction: $
Total: $
Indicate the estimated date for Federal-aid
Authorization & Obligation or Check the box:
Date:
Not needed for this project
Not needed for this project
Not needed for this project
VALUE ENGINEERING ANALYSIS
Required (Yes, if on the NHS and total project costs
for bridges are $40M or more) Yes No
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
Remarks:
***** The following must be attached if the project is funded by the HBP:
1. Plan view of proposed improvements.
2. Typical Section.
***** The following is recommended:
1. Right of way map to determine whether right of way acquisition or construction easements
are necessary.
Distribution: Attach to Field Review Form
+ Contingency
$ 110,000
$ 270,000
$ 451,000
$ 270,600
$ 100,000
$ 100,000
$ 164,000 + $451,000
$ 3,076,600
451,000
200,000
2,425,600
03/01/2017
01/01/2019
01/01/2020
3,076,600
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
Exhibit
Right‐of‐Way Maps