Signed Contract_2805 Jackson Street_Revocable License, Convivium Urban Farmstead Copyrighted
May 7, 2018
City of Dubuque Consent Items # 27.
ITEM TITLE: Signed Contract(s)
SUMMARY: Revocable License for Convivium Urban Farmstead, 2805
Jackson Street for a geothermal drain pipe along the White
Street right-of-way.
SUGGESTED DISPOSITION: Suggested Disposition: Receive and File
THE CITY OF
DJU1
Masterpiece on the Mississippi
TO: Michael C. Van Milligen, City Ma
FROM: Gus Psihoyos, City Engineer
DATE: April 11, 2018
RE: Revocable License — 2805 Jackson St.
INTRODUCTION
Dubuque
Allatela
"11'
2007.2012
2013.2017
This is in response to a request from Mike Muench owner of Convivium Urban
Farmstead, 2805 Jackson St., who is requesting permission for the drain pipe along city
right of way on White Street to dump their pump/dump geothermal well system.
BACKGROUND
In November 2016 you approved the Convivium facility to discharge into the City's
storm sewer system with conditions regarding maximum discharge, submittal of design
plans and obtaining the NPDES permit from the Iowa Department of Natural Resources,
metering, as well as other requirements. The November 14, 2016 letter to Mr. Muench
is attached for your reference.
DISCUSSION
Engineering staff has reviewed the location of the drain pipe into the catch basin at the
northeast corner of 28th and White Street, the NPDES permit, and Building Services has
reviewed the design of the geothermal systems and Water Department has reviewed
the well data.
The public right-of-way of White Street is 40' with 28' curb to curb, leaving 6' back of
curb to right of way line. The eight -inch (8") diameter drain pipe has been placed under
the walk on the east side of White Street from the Convivium facility for a length of 150
foot to the catch basin at the northeast corner of E. 28th St. and White St. Attached is a
drawing showing the placement location.
All the required documents have been received which include the License Application,
signed Acceptance of Terms, and Certificate of Insurance. Engineering, Water and
Building Services have reviewed the request and documents and have found them to be
acceptable.
BUDGET IMPACT
The payment of the $250.00 application fee will be recorded as part of the CIP
10055400-42170 revenue.
Masterpiece on the Mississippi
November 14, 2016
Mr. Mike Muench
Convivium Urban Farmstead
2811 Jackson Street
Dubuque, IA 52001
Dubuque
AA-AmencaCity
20e7 2012 • 2013.
City Manager's Office
50 W. 13`b Street
Dubuque, IA 52001
Office (563) 589-4410
Fax (563) 589-4149
TDD (563)556-9948
citymanager@cityoftlubuque.org
www.cityofdubuque.org
RE: Geothermal Discharge Approval — Convivium Urban Farmstead facility located at
2811 Jackson Street
Dear Mr. Muench:
This letter serves as written approval for the geothermal heating and cooling system at
the Convivium facility located at 2811 Jackson Street to discharge into the City's storm
sewer system.
The approval is based on an average maximum discharge of 10 GPM (gallons per
minute) with occasions up to 45 GPM to the City storm sewer and with the following
conditions:
1. Convivium must submit a design plan for the geothermal heating and cooling
system for review and approval by the City;
2. Convivium must obtain a NPDES permit from the Iowa Department of Natural
Resources for the City to allow the discharge into the City's storm sewer
system;
3. The system must discharge directly into the City storm sewer system. The
closest City storm sewers are located at:
a. Intersection of 28th & Jackson Street, or
b. 28th & White Street.
This will require a revocable license for installation and maintenance of a
private discharge pipe in either the Jackson Street or White Street public
right-of-way.
4. The discharge into the City storm sewer is limited to groundwater that does
not come into contact with raw materials, intermediate products, finished
products, or process wastes;
5. A flow meter must be installed so that flows can be reported to the City upon
request;
6. Well data (location, depth, GPM, etc.) must be submitted to Brant Schueller at
the City of Dubuque Water Department. When the building addition and
system are finished, City staff will field verify plumbing for any cross
connections;
7. The City may charge a Stormwater Management Utility fee for the discharge
of the geothermal system into the City's stormwater management system;
and
8. This authorization can be revoked at any time by the City Manager if, in the
sole discretion of the City Manager, the geothermal discharge presents a
danger to public property, private property, the environment, or the health or
welfare of persons or a determination of a violation of the outlined conditions.
If you need any further assistance or information, please contact Civil Engineer Deron
Muehring at (563) 589-4270.
Sincerely,
Michael C. Van Milligen
City Manager
cc: Crenna Brumwell, City Attorney
Barry Lindahl, Senior Counsel
Gus Psihoyos, City Engineer
Denise Ihrig, Environmental Engineer
Deron Muehring, Civil Engineer II
Bob Green, Water Department Manager
Brant Schueller, Water Distribution Manager
Prepared by:
Return to:
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Doc ID 008806460006 Type GEN
Kind: MISCELLANEOUS
Recorded: 04/19/2018 at 02:09:26 PM
Fee Amt: $32.00 Page 1 of 6
Dubuque County Iowa
John Murphy Recorder
F11e2018-00004052
Gus Psihoyos, City Engineer, City of Dubuque, 50 W. 13th Street, Dubuque, IA 52001 (563 589-4270)
Gus Psihoyos, City Engineer, City of Dubuque, 50 W. 13th Street, Dubuque, A 52001 (563 589-4270)
REVOCABLE LICENSE
AUTHORIZING CO.hv o v uon tiv-60-n c-f4s)A to 6-d
TO CONSTRUCT 4-'),1-7) r^ vvv
ON PUBLIC RIGHT-OF-WAY
Section 1. .k,k,)e ilCk/ ovw) u i uvtil as the owner of the premises,
(business) (Licensee), known as ' 'a 11 •J -(c So in
Dubuque, Iowa, and legally described as Loi-- `R\ ict 1t z Ni unser Cub.
be and is hereby granted a Revocable License and authority to construct and raintain
S vo , (Encroachment) (see attachment for
location) under the terms and conditions set forth in this License.
Section 2. The permission herein granted is expressly conditioned on
Licensee's agreement to:
a. Assume any and all liability for damages to persons or property which may
result from the existence, location, installation, construction or
maintenance of said Encroachment;
b. Procure and maintain in force during the term of this License a policy of
liability insurance as set forth in the attached Insurance Schedule or
private policy of liability insurance which covers your encroachment of the
public right of way; as required by the City Manager
c. Pay on behalf of the City of Dubuque, all sums which the City of Dubuque
shall become obligated to pay by reason of the liability imposed upon the
City of Dubuque for damages of any kind resulting from the location,
installation, existence, construction or maintenance of said Encroachment
sustained by any person or persons, caused by accident or otherwise to
defend at its own expense and on behalf of said City any claim against the
City of Dubuque arising out of the location, installation, existence,
construction or maintenance of Encroachment and to pay reasonable
attorney fees therefor; and
d. Indemnify, defend and hold the City of Dubuque free and harmless from
any and all claims, including but not limited to damages, loss, liability and
expense for death and/or injuries to third persons or damages to property
of third persons, or for damage to any property of the City of Dubuque
which may occur as a result of or in connection with the location,
installation, existence, construction, maintenance and repair of
Encroachment.
e. Any special conditions as set forth for this License as identified:
Section 3. The Encroachment shall be maintained in accordance with all
applicable state and federal laws and regulations, and the Ordinances of the City of
Dubuque.
Section 4. The permission herein granted is expressly conditioned upon
Licensee's further agreement that should the right and privilege herein granted be
rescinded or revoked by the City Manager, with or without cause, Licensee, shall within
ten (10) days after receipt of written notice from the City Manager, so to do, at its own
expense, remove said Encroachment at Licensee's expense and dispose of the same,
and Licensee shall have no claim against the City or its officers, agents, or employees
for damages resulting from the removal of said Encroachment.
Section 5. Licensee covenants and agrees that the Revocable License herein
granted does not constitute an approval of the design, erection, location, construction,
repair or maintenance of said Encroachment and Licensee hereby covenants and
agrees not to assert such claim or defense against the City of Dubuque in the event of
claim asserted for death, personal injuries and/or property damage against Licensee
arising out of or in any way connected with the location, installation, construction,
design, repair and maintenance of the Encroachment.
Section 6. This Revocable License shall become effective and the rights
hereunder accrue to Licensee when this License has been approved by the City
Manager and the terms and conditions thereof accepted by Licensee by acceptance
endorsed on this License. This Revocable License is not assignable or transferable to
another location. This license is for this property only.
Section 7. The City Clerk shall file a copy of this License at Licensee's
expense in the Office of the Recorder in and for Dubuque County, Iowa.
2
Section 8. Iowa One -Call registration may be required by the Code of Iowa.
When applicable Licensee shall submit documentation to the City Engineer of Iowa
One -Call registration membership.
Signed this 16 day of 4/9 ` , 20 #.
M ` ael C. Van Milligen, City Manager
Attest:
Kevi . irnstahl, City Ierk
State of Iowa )
) ss:
County of Dubuque )
On this day of/ , before me, the
undersigned, a Notary Public in and for th State of Iowa, personally appeared Michael
C. Van Milligen and Kevin S. Firnstahl, to me personally known, who, being by me duly
sworn, did say that they are the City Manager and City Clerk, respectively, of the City of
Dubuque, Iowa, a municipal corporation, that the seal affixed to the foregoing
instrument is the corporate seal of the corporation, and that the instrument was s' ned
and sealed/ beh f of the cor oration, by authority of its City Council, on the
day of #4, , and Michael C. Van Milligen and Kevin S. Firnstahl
acknowledg;'d the execution of the instrument to be their vnfary act and deed.
PAMELA J. McCARRON
Commission Num✓er 772419
!illy Comm. Exp. v ;,Z01
///
otary Pub i and for said State
3
ACCEPTANCE OF TERMS AND CONDITIONS OF LICENSE
The undersigned, being duly authorized to execute this Acceptance on behalf of
NINO-IV/ UW/1 1,4,060-0 Feic*A-tea di,i4STITIGNAtirb read and being familiar with the terms
and conditions of the Revocable License, accepts the same and agrees to be bound by
the terms and conditions herein.
LICENSEE:
S gnature
By: vvV‘ tGz m u e-AA.c..h
Title: O,..e) v\ -e(
Dated: 5- Li --D.00(7
Signature requires notary — Use "All Purpose Acknowledgement" on next page
4
ALL PURPOSE ACKNOWLEDGMENT
STATE OF IOWA )
COUNTY OF DUBUQUE )
ti
a
; . .�,
On this % day of /'/0-) , 20 /,!>before me, the undersigned, a
Notary Public in and for said State, pers?finally appeared /2- 0 `�'�)Lse,( c't.
(NAME/S) to me personally known, OR proved to me on the basis of
satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within
instrument and acknowledged to me that he/she/they executed the same in his/her/their
authorized capacity(ies), and that by his/her/their signature(s) on the instrument the
person(s) acted, executed the instrument.
(Notary Seal)
JUANITA HILKIN
Commission Number 7
Ely Commission Expires
,'1
2' gign in ink)
////y )7Z,ctiyt i/I-1( (print/type name)
Notary Public in and for State of Iowa
CAPACITY CLAIMED BY SIGNER
INDIVIDUAL
CORPORATE OFFICER(S) (Title)
(CORP SEAL)
AFFIXED
NO SEAL PROCURED
PARTNER(S) LIMITED GENERAL
ATTORNEY-IN-FACT
TRUSTEE(S)
GUARDIAN/CONSERVATOR
OTHER
SIGNER IS REPRESENTING:
Name of Person(s) or Entity(ies):
5
THE CITY OF
DUB
Masterpiece on the Mississippi
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This Information was compiled
the Dubuque Area Geographic Information System
(DAGIS), which includes data created by both the City of
Dubuque and Dubuque County. It is understood that, while
the City of Dubuque and participating agencies utilized the
most current and accurate information available, coo DAGIS and
ins suppliers do not warrant the rein. The or ityrandcp of the
information ll data contained lia a herein. iCity and pa, ini incidental, agencies shall not bee, o liable al any direct, whether r, reseeable
consequential, punitive, special damages, whether Foreseeable or
unforeseeable, or inability out
the aized or ofa brieac use of
this data or the inability to use this data or out of any breach of
warrants whatsoever.
60
2804
1 inch = 68 feet
30
0
60 Feet
2784
W E
Map Prepared by:
City of Dubuque
Engineering Division
50 West 13th Street
Dubuque, Iowa 52001
Phone: (563) 589-4270
Fax: (563) 589-4205
IOWA DEPARTMENT OF NATURAL RESOURCES
National Pollutant Discharge Elimination System (NPDES) Permit
OWNER NAME & ADDRESS FACILITY NAME & ADDRESS
Convivium Urban Farmstead
2805 Jackson St.
DUBUQUE, IA 52001-0000
IOWA NPDES PERMIT NUMBER: 3126202
DATE OF ISSUANCE: 09/01/2017
DATE OF EXPIRATION: 08/31/2022
Convivium Urban Farmstead
2805 Jackson St.
DUBUQUE, IA 52001 -
Section 13, T89N, RO2E
Dubuque County
YOU ARE REQUIRED TO FILE FOR RENEWAL
OF THIS PERMIT BY: 03/04/2022
EPA NUMBER: 1A0052864
This permit is issued pursuant to the authority of section 402(b) of the Clean Water Act (33 U.S.0
1342(b)), Iowa Code section 455B.174, and rule 567-64.3, Iowa Administrative Code, You are
authorized to operate the disposal system and to discharge the pollutants specified in this permit in
accordance with the effluent limitations, monitoring requirements and other terms set forth in this
perniit.
You may appeal any condition of this permit by filing a written notice of appeal and request for
administrative hearing with the director of this department within 30 days of your receipt of this permit.
Any existing unexpired Iowa operation permit or Iowa NPDES permit previously issued by the
department for the facility identified above is revoked by the issuance of this permit. This provision
does not apply to any authorization to discharge under the terms and conditions of a general permit
issued by the department or to any permit issued exclusively for the discharge of stormwater.
FOR THE DEPARTMENT OF NATURAL RESOURCES
By
Julie Faas
NPDES Section
ENVIRONMENTAL SERVICES DIVISION
Shawver Well Company, Inc.
2700 Stanley Avenue
Fredericksburg, IA 50630
(563) 237-5341
(800) 568-4449
Location of Well
2805 Jackson Street
Dubuque, IA 52001
T89N R2 -3E
Customer Information
Michael Muench
Leslie Shalabi
Convivium Urban Farms
2805 Jackson Street
Dubuque, IA 52001
Job Information
Area FB
T89N R2 -3E
Latitude 42.52358
Longitude -90.67799
PWTS # 2194462
Permit Number 49060
Well Formation
From -To Color
0 - 4 Black
4 16 Gray -
Brown
Log
Formation
Topsoil
Clay
County Dubuque
TownshipDubuque
Section 13
Quarters City Limits
Confirmation
Start Date
End Date
Warranty Date
Warranty
16 - 82 Sand - Medium to Coarse
82 - 98 Cream Limestone
Gray -
98 - 124 Brown Limestone
124 - 160 White Sandstone
160 - 178 Blue Shale & Limestone
178 - 191 Cream Limestone
191 - 193 Shale Soft
193 - 243 Shale & Limestone
243 274 Cream Limestone
274 - 289 Light
Brown
289 - 328 Red
Brown
Pink
Red
Brown -
Red
Cream -
400 - 456 Brown - Limestone
Pink
456 - 468 Tan Limestone & Sandstone Mix
Brown -
Tan
328 - 341
341 - 346
346 - 400
Limestone
Shale & Limestone
Limestone
Shale - Rock
Limestone with Shale Seams
468 - 474
LI mestone
/2/2017
/12/2017
Well Site Info
Actual Size 7
Depth' 474'
Elevation
SWL 12'
120'
RPS @ 50
GPM
Max GPM 100.
Air Lift 120'
@ 60
GPM;
474'
@ 100
GPM
Exploratory'- To
Mock Rock Acidize
Well Use
Drill
Remarks:
Bore, Log
From -To
0 - 38
38 - 186
186 - 474
Dave Halw
2814
ion
Pump Inst -- Liner V2g0ft
Sulfide -- Screen --
Made Water 328'; 362'; 456'
Screen Size
Siot Size
Riser Pipe
Set From 5" PVC liner: 184'-474'
5" PVC liner:
Perforated From 320`-340'; 360'-380';
400'-474'
Tail Pipe
Sr; Cert #:.
Bit' Size - Number
12 1/4"
9 7/8"
6 1/4"
Well Casing Log
From -To Casing
7" x .317"
Steel
7" x .317"
Steel
184 - 474 '5" x'. PVC Liner
0-186
2-0
Screen Size
Slot Size
Riser Pipe
:Well Grout Used
Amount
91 sacks
10 sacks
Type
Neat Cement
EZ Seal
Set From 5" PVC liner: 184'-474'
Tail Pipe