Public Works, Sewer and Water
Regular MeetingVerona, WI · April 11, 2022
Minutes
CITY OF VERONA
MINUTES
PUBLIC WORKS/SEWER & WATER COMMITTEE
MONDAY, APRIL 11, 2022
1. The meeting was called to order by Mr. Touchett at 5:18pm.
2. Roll Call: Present: Evan Touchett, Mara Helmke, Chad Kemp. Also present: Theran Jacobson, Director of Public
Works; Carla Fischer, AECOM, City Engineer.
3. MOVED by Touchett, seconded by Kemp, to approve the minutes of the March 14, 2022, meeting of the Public
Works/Sewer and Water Committee. Motion carried 3-0.
4. MOVED by Touchett, seconded by Helmke, to recommend awarding Project 2022-108, Wildcat Way water
main project, to Maddrell Excavating, LLC of Brodhead, WI, in the amount not to exceed $267,751.59. Motion
carried 3-0. Touchett noted he thinks Jacobson smartly times public works project bids.
5. MOVED by Touchett, seconded by Helmke, to recommend approving change order No. 6 for Project 2018-108,
Eastside Interceptor replacement project, in the amount not to exceed $6,906.00. Motion carried 3-0.
6. MOVED by Touchett, seconded by Kemp, to recommend approving change order No. 7 for Project 2018-108,
Eastside Interceptor replacement project, in the amount not to exceed $17,795.20. Motion carried 3-0.
7. Fischer provided an overview of the Municipal Separate Storm Sewer System annual report for 2021. City staff
provided supporting documentation to AECOM who formalizes the 2021 annual report for the maintenance
activities on the storm water utility. The report was submitted to the Wisconsin Department of Natural
Resources on March 31, 2022 and is required to be presented to the committee. The report summarizes the
following activities:
• Public education and outreach
Presentations prepared and executed by Marty Cieslik, Construction Manager, now
retired. AECOM is now facilitating the future presentations with new topics to be
determined. Presentations will be recorded and available virtually.
• Storm sewer outfall illicit discharge inspections and documentation
These inspections determine if there are any unknown or unanticipated flows in the
storm sewer system during dry weather to find a cross connection. There are no known
cross connections or unanticipated flows resulting from the inspections. There are
known cooling water discharges from industrial sources that are documented.
• Construction permits issued and inspections
Issuance of erosion control permits and inspection report
• Street & curb side material management
Sweeping
Material collection and usage
• Updated mapping
Addition of storm water management assets (pipe and treatment facilities)
MOVED by Touchett, seconded by Kemp to approve submittal of the Municipal Separate Storm Sewer System
(MS4) 2021 annual report to the WI DNR. Motion carried 3-0.
8. MOVED by Touchett, seconded by Kemp adjourn at 5:47pm. Motion carried 3-0.
Note: These minutes were prepared by Theran Jacobson, Director of Public Works. These minutes are based
on the notes of the recorder and are subject to change at a subsequent meeting.
Agenda
CITY OF VERONA
AMENDED
PUBLIC WORKS/SEWER & WATER COMMITTEE AGENDA
MONDAY, APRIL 11, 2022
5:15 P.M.
VERONA CITY CENTER, ROOM D122
111 LINCOLN STREET
VERONA, WI 53593
Agenda Items
1. Call to order.
2. Roll call.
3. Approval of the minutes of the March 14, 2022 meeting of the Public Works/Sewer and Water
Committee.
4. Discussion and action regarding awarding Project 2022-108, Wildcat Way water main project.
5. Discussion and action regarding Change order no. 6 for Project ID 2018-108 Eastside Interceptor
replacement project.
6. Discussion and action regarding Change order no. 7 for Project ID 2018-108 Eastside Interceptor
replacement project.
7. Discussion and action regarding Municipal Separate Storm Sewer System (MS4) 2021 annual report.
8. Adjourn.
Evan Touchett
Chairperson
Notice is hereby given that a majority of the City Council may be present at the meeting of the Public Works/Sewer &
Water Committee to gather information about a subject over which they have decision-making responsibility.
POSTED: Verona City Hall
Verona Library
Miller’s Market
ALL AGENDAS ARE POSTED ON THE CITY’S WEBSITE AT www.ci.verona.wi.us
IF YOU NEED AN INTERPRETER, MATERIALS IN ALTERNATIVE FORMATS, OR OTHER ACCOMMODATION TO
ACCESS THE MEETINGS, PLEASE CONTACT THE CITY CLERK AT 845-6495 AT LEAST 48 HOURS PRECEDING THE
MEETING. EVERY REASONABLE EFFORT WILL BE MADE TO ACCOMMODATE YOUR REQUEST.
CITY OF VERONA
MINUTES
PUBLIC WORKS/SEWER & WATER COMMITTEE
MONDAY, MARCH 14, 2022
1. The meeting was called to order by Mr. Touchett at 5:16pm.
2. Roll Call: Present: Evan Touchett, Mara Helmke. Chad Kemp arrived at 5:22pm. Also present: Theran Jacobson,
Director of Public Works; Carla Fischer, AECOM, City Engineer.
3. MOVED by Touchett, seconded by Helmke, to approve the minutes of the February 14, 2022 meeting of the
Public Works/Sewer and Water Committee. Motion carried 2-0.
4. MOVED by Touchett, seconded by Helmke, to recommend awarding Project 2022-101, Verona Asphaltic Street
Rehabilitation to Wolf Paving & Excavating of Madison, WI, in the amount not to exceed $195,990.00. Motion
carried 3-0.
5. MOVED by Touchett, seconded by Kemp, to recommend awarding contract for Project 2022-102, Verona
Pavement Surface Treatment to Scott Construction of Lake Delton, WI in the amount not to exceed
$173,482.50. Motion carried 3-0.
6. MOVED by Touchett, seconded by Kemp adjourn at 5:28pm. Motion carried 3-0.
Note: These minutes were prepared by Theran Jacobson, Director of Public Works. These minutes are based
on the notes of the recorder and are subject to change at a subsequent meeting.
Meeting Date: April 11, 2022
PW/S&W Committee Memo
Public Works/Sewer & Water Committee
Listed below is an explanation of the items on the Public Works/Sewer & Water Committee
agenda.
Item (4) Awarding Project 2022-108, Wildcat Way Water Main Project
Four (4) bids were received and are listed below in order lowest to highest:
• Maddrell Excavating, LLC of Brodhead, WI in the amount of $267,751.59.
• Parisi Construction Co. Inc. of Verona, WI in the amount of $283,140.29.
• E & N Hughes Co. Inc. of Monroe, WI in the amount of $293,379.30.
• Speedway Sand & Gravel Inc of Middleton, WI in the amount of $399,876.54.
The engineer’s estimate with contingencies was $263,767.80.
The item of 10-Inch Ductile Iron Water Main was the main factor in the difference in the
engineer’s estimate and the contractor’s bids. Current supply chain issues are believed to be
the main contributors to this cost difference.
Maddrell Excavating, LLC has successfully completed a number of other utility projects
throughout the City of Verona; most recently the 2021 N. Main Water Main Replacement, the
2020 annual pond dredging, and the 2018 S. Shuman & W. Park Lane replacement. Based on
past work performed in the City of Verona and references checked, Public Works Staff is of the
opinion that Maddrell Excavating has the personnel, equipment and financial assets necessary
to complete the 2022-108, Wildcat Way Water Main Extension Project.
Item (5) Change order no. 6 for Project ID 2018-108 Eastside Interceptor Replacement.
Change order no. 6 for the Eastside Interceptor Project is for additional work required as part of
Project A, which is a City of Verona and MMSD facilitated and financed project component.
The change order is to add additional bid items to complete the work and improve drainage
conditions along the Badger Mill Creek Corridor:
• Storm sewer adjacent to the Ice Age Trail on the north side of Badger Mill Creek.
o Removed and replaced a CMP culvert estimated to be installed in the 1960s that
was unknown to any project staff until encountered in the field.
• Repaired an existing sanitary manhole that was a source of inflow and infiltration.
The contract notes are as follows:
• Contract award value = $7,761,804.60
• Previous change orders = $288,893.50 (add)
• Change order No. 6 = $6,906.00 (add)
Page 1 / 2
Meeting Date: April 11, 2022
PW/S&W Committee Memo
• Contract value after incorporating this change order = $8,057,604.10
Staff recommends approval of change order no. 6.
Item (6) Change order no. 7 for Project ID 2018-108 Eastside Interceptor Replacement.
Change order no. 7 for the Eastside Interceptor Project is for additional work required as part of
Project A, which is a City of Verona and MMSD facilitated and financed project component.
The change order is to add additional bid items to complete the work along the Badger Mill
Creek Corridor, this work is all under Project B which is work facilitated and financed by Dane
County:
• Work included transporting stockpiled trees from streambank work to a location outside
of the project limits for County use at a later date.
o It is anticipated that the County will be re-using the material as mulch.
The contract notes are as follows:
• Contract award value = $7,761,804.60
• Previous change orders = $295,799.50 (add)
• Change order No. 7 = $17,795.20 (add)
• Contract value after incorporating this change order = $8,075,399.30
Staff recommends approval of change order no. 7.
Item (7) Municipal Separate Storm Sewer System (MS4) 2020 annual report.
City staff has prepared the 2021 annual report for the maintenance activities on the storm
water utility. The report was submitted to the Wisconsin Department of Natural Resources on
March 31, 2022 and is to be presented to the committee. The report summarizes the following
activities:
• Public education and outreach
• Storm sewer outfall illicit discharge inspections and documentation
• Construction permits issued and inspections
• Street & curb side material management
• Updated mapping
Included in the packet is the executive summary submitted to the WDNR which lists all the
attachments included with the report.
Page 2 / 2
City of Verona
Public Works Department
410 Investment Court
Verona, WI 53593
Phone: (608) 845-6695 Fax: (608) 845-5761
Email: theran.jacobson@ci.verona.wi.us
April 4, 2022
Verona City Council Members
111 Lincoln Street
Verona, WI 53593
Subject: Letter of Recommendation
2022‐108, Wildcat Way Water Main Extension Project
Dear Council Members:
In accordance with the Official Notice to Bidders, the office of the Public Works Director
accepted sealed bids for the above named project until 11:00 a.m. local time on March 22,
2022. Following the close of bidding, the bids received were publicly opened virtually via Zoom
and read aloud. Staff has reviewed the bids received. A copy of the Bid Tabulation is attached.
Four (4) bids were received and are listed below in order lowest to highest:
Maddrell Excavating, LLC of Brodhead, WI in the amount of $267,751.59.
Parisi Construction Co. Inc. of Verona, WI in the amount of $283,140.29.
E & N Hughes Co. Inc. of Monroe, WI in the amount of $293,379.30.
Speedway Sand & Gravel Inc of Middleton, WI in the amount of $399,876.54.
The engineer’s estimate with contingencies was $263,767.80.
The item of 10‐Inch Ductile Iron Water Main was the main factor in the difference in the
engineer’s estimate and the contractor’s bids. Current supply chain issues are believed to be
the main contributors to this cost difference.
Maddrell Excavating, LLC has successfully completed a number of other utility projects
throughout the City of Verona; most recently the 2021 N. Main Water Main Replacement, the
2020 annual pond dredging, and the 2018 S. Shuman & W. Park Lane replacement. Based on
past work performed in the City of Verona and references checked, Public Works Staff is of the
opinion that Maddrell Excavating has the personnel, equipment and financial assets necessary
to complete the 2022‐108, Wildcat Way Water Main Extension Project.
I would therefore recommend that the City of Verona accept the bid of Maddrell Excavating for
the 2022‐108, Wildcat Way Water Main Extension Project and recommend awarding a contract
to Maddrell Excavating in the amount of $267,751.59.
Project ID 2022‐108
I will be pleased to answer any questions concerning the recommendations set forth.
Thank you in advance for your cooperation.
Sincerely,
Theran P. Jacobson, P.E.
Public Works Director
Drafted / reviewed by:
EAS/tpj
S:\PROJECTS\2022-108_WILDCAT WAY WATER MAIN CONNECTION\DESIGN - PERMITTING - BIDDING\BIDDING\LETTER OF
RECOMMENDATION\2022-108, WILDCAT WAY WATER MAIN EXTENSION LETTER OF RECOMMENDATION_2022-04-01.DOCX
Project ID 2022‐108
BID TABULATION
BID TABULATION
2022-108, Wildcat Way Water Main Extension Project
CITY OF VERONA, WISCONSIN
Bid Date: 22-Mar-22 11:00 Bid Time
2022-108, Wildcat Way Water Main Extension Project
For
City of Verona, Wisconsin
Engineers Estimate Maddrell Excavating LLC Parisi Construction, LLC E & N Hughes Co. Inc. Speedway Sand & Gravel Inc
Item Description Quantity Units Unit Price Total Unit Price Total Unit Price Total Unit Price Total Unit Price Total
1201.0100.S Clearing and Grubbing 10 STA $ 900.00 $ 9,000.00 $ 500.00 $ 5,000.00 $ 1,700.00 $ 17,000.00 $ 1,913.00 $ 19,130.00 $ 1,663.60 $ 16,636.00
1204.0170 Removing Fence 88 LF $ 3.00 $ 264.00 $ 20.00 $ 1,760.00 $ 8.00 $ 704.00 $ 13.00 $ 1,144.00 $ 22.50 $ 1,980.00
1465.0120.S Remove and Replace Asphaltic Driveway and Dense Graded Base 45 SY $ 200.00 $ 9,000.00 $ 150.00 $ 6,750.00 $ 140.00 $ 6,300.00 $ 73.00 $ 3,285.00 $ 110.00 $ 4,950.00
1606.0200 Riprap Medium 15 CY $ 75.00 $ 1,125.00 $ 65.00 $ 975.00 $ 98.00 $ 1,470.00 $ 103.00 $ 1,545.00 $ 74.00 $ 1,110.00
1616.0206.S Fence Chain Link Security 6-FT 88 LF $ 50.00 $ 4,400.00 $ 65.00 $ 5,720.00 $ 86.00 $ 7,568.00 $ 16.00 $ 1,408.00 $ 78.00 $ 6,864.00
1619.1000 Mobilization 1 LS $ 35,000.00 $ 35,000.00 $ 31,500.00 $ 31,500.00 $ 67,000.00 $ 67,000.00 $ 11,650.00 $ 11,650.00 $ 39,310.00 $ 39,310.00
1625.0100 Topsoil, 6-Inch 4237 SY $ 5.50 $ 23,303.50 $ 0.25 $ 1,059.25 $ 3.00 $ 12,711.00 $ 2.70 $ 11,439.90 $ 1.00 $ 4,237.00
1628.0100.S Temporary Waterway Crossing 1 LS $ 4,000.00 $ 4,000.00 $ 250.00 $ 250.00 $ 500.00 $ 500.00 $ 7,383.00 $ 7,383.00 $ 2,950.00 $ 2,950.00
1628.1504 Silt Fence 1000 LF $ 2.00 $ 2,000.00 $ 2.50 $ 2,500.00 $ 2.30 $ 2,300.00 $ 3.80 $ 3,800.00 $ 1.95 $ 1,950.00
1628.2008 Erosion Mat Urban Class I Type B 4200 SY $ 2.00 $ 8,400.00 $ 1.95 $ 8,190.00 $ 2.10 $ 8,820.00 $ 2.30 $ 9,660.00 $ 1.85 $ 7,770.00
1628.2021 Erosion Mat Class II Type C 37 SY $ 6.00 $ 222.00 $ 9.00 $ 333.00 $ 8.30 $ 307.10 $ 18.70 $ 691.90 $ 5.00 $ 185.00
1628.7504 Temporary Ditch Checks 50 LF $ 10.00 $ 500.00 $ 10.00 $ 500.00 $ 13.00 $ 650.00 $ 32.60 $ 1,630.00 $ 7.50 $ 375.00
1630.0100.S Flood Plain Seed Mix 1 LB $ 200.00 $ 200.00 $ 600.00 $ 600.00 $ 670.00 $ 670.00 $ 116.00 $ 116.00 $ 586.00 $ 586.00
1630.0175 Seeding Mixture No. 75 26 LB $ 40.00 $ 1,040.00 $ 105.00 $ 2,730.00 $ 82.00 $ 2,132.00 $ 41.00 $ 1,066.00 $ 101.93 $ 2,650.18
1630.0200.S Sterile Cover Crop 28 LB $ 15.00 $ 420.00 $ 20.00 $ 560.00 $ 36.00 $ 1,008.00 $ 14.75 $ 413.00 $ 18.00 $ 504.00
1643.5000 Traffic Control 1 LS $ 1,000.00 $ 1,000.00 $ 1,500.00 $ 1,500.00 $ 520.00 $ 520.00 $ 1,740.00 $ 1,740.00 $ 3,800.00 $ 3,800.00
1645.0120 Geotextile Type HR 30 SY $ 4.00 $ 120.00 $ 7.00 $ 210.00 $ 5.70 $ 171.00 $ 1.85 $ 55.50 $ 6.00 $ 180.00
1650.1000 Construction Staking Project 1 LS $ 5,000.00 $ 5,000.00 $ 3,350.00 $ 3,350.00 $ 3,100.00 $ 3,100.00 $ 6,150.00 $ 6,150.00 $ 3,000.00 $ 3,000.00
1690.1000 Sawing Pavement 60 LF $ 3.00 $ 180.00 $ 5.00 $ 300.00 $ 10.25 $ 615.00 $ 4.00 $ 240.00 $ 9.00 $ 540.00
2204.1215.S Remove and Reset 15-Inch Reinforced Concrete Pipe and Apron Endwall 1 LS $ 4,500.00 $ 4,500.00 $ 2,750.00 $ 2,750.00 $ 4,700.00 $ 4,700.00 $ 2,550.00 $ 2,550.00 $ 3,400.00 $ 3,400.00
2612.0106.S Remove and Reinstall Pipe Underdrain 6-Inch 25 LF $ 10.00 $ 250.00 $ 15.00 $ 375.00 $ 34.25 $ 856.25 $ 61.00 $ 1,525.00 $ 25.00 $ 625.00
3209.3000 Trench Backfill (Water Main) 34 TF $ 32.00 $ 1,088.00 $ 0.01 $ 0.34 $ 0.01 $ 0.34 $ 46.00 $ 1,564.00 $ 29.20 $ 992.80
3801.0110 10-Inch Dia. Ductile Iron Water Main 1064 LF $ 80.00 $ 85,120.00 $ 163.00 $ 173,432.00 $ 115.00 $ 122,360.00 $ 167.00 $ 177,688.00 $ 253.07 $ 269,266.48
3803.0106 Water Valve and Valve Box (6-inch) 1 EA $ 2,800.00 $ 2,800.00 $ 2,475.00 $ 2,475.00 $ 3,200.00 $ 3,200.00 $ 1,994.00 $ 1,994.00 $ 3,073.00 $ 3,073.00
3803.0110 Water Valve and Valve Box (10-inch) 1 EA $ 4,100.00 $ 4,100.00 $ 2,950.00 $ 2,950.00 $ 5,000.00 $ 5,000.00 $ 3,657.00 $ 3,657.00 $ 4,750.00 $ 4,750.00
3804.0106 Hydrant Lead, 6-Inch 6 LF $ 75.00 $ 450.00 $ 95.00 $ 570.00 $ 150.00 $ 900.00 $ 120.00 $ 720.00 $ 121.88 $ 731.28
3805.0100.S Fire Hydrant 1 EA $ 6,000.00 $ 6,000.00 $ 5,850.00 $ 5,850.00 $ 5,800.00 $ 5,800.00 $ 6,196.00 $ 6,196.00 $ 7,321.00 $ 7,321.00
3806.1000 Insulation, Polystyrene 128 SF $ 8.00 $ 1,024.00 $ 4.00 $ 512.00 $ 6.70 $ 857.60 $ 3.00 $ 384.00 $ 6.60 $ 844.80
3807.0110 Connect to Existing Water Main (10-Inch) 2 EA $ 3,000.00 $ 6,000.00 $ 1,850.00 $ 3,700.00 $ 2,500.00 $ 5,000.00 $ 4,382.00 $ 8,764.00 $ 3,835.00 $ 7,670.00
3809.0406 Remove Water Valve (6-Inch) 1 EA $ 800.00 $ 800.00 $ 350.00 $ 350.00 $ 180.00 $ 180.00 $ 1,930.00 $ 1,930.00 $ 400.00 $ 400.00
3809.0410 Remove Water Valve (10-Inch) 1 EA $ 1,000.00 $ 1,000.00 $ 350.00 $ 350.00 $ 180.00 $ 180.00 $ 1,930.00 $ 1,930.00 $ 400.00 $ 400.00
3809.0500 Remove Hydrant 1 EA $ 1,500.00 $ 1,500.00 $ 650.00 $ 650.00 $ 560.00 $ 560.00 $ 1,930.00 $ 1,930.00 $ 825.00 $ 825.00
Bid Total $ 219,806.50 $ 267,751.59 $ 283,140.29 $ 293,379.30 $ 399,876.54
Contingency 20% $ 43,961.30 Bid Bond 5% 5% 5% 5%
Total w. Contingency $ 263,767.80
* - Apparent Low Bidder
2022-108, WIldcat Way Water Main Extension Bid Tab.xlsx
CHANGE ORDER NO. 6
Owner City of Verona Date 01/28/2022
Project East Side Interceptor/MMSD Pump Station 17 Force Main Relief Owner’s Contract No. 2018-108
Contractor Minger Construction Companies, Inc. Date of Contract Start October 13, 2020
You are directed to make the following changes in the Contract Documents.
These changes will be incorporated into the Project A portion of the contract. These additions will be paid for solely by the City of
Verona.
Adding Items
Item Number Description Quantity Unit Unit Price Amount
2204.1221 (CO.06.01) Removing Storm Sewer 21-inch and less 30 LF $ 12.00 $ 360.00
2521.1024 (CO.06.02) Apron Endwalls for Culvert Pipe Steel 24-Inch 2 EA $ 1,101.00 $ 2,202.00
2608.3024 (CO.06.03) Storm Sewer Pipe Class III-A 24-Inch 40 LF $ 58.60 $ 2,344.00
CO.06.04 Existing MH SA 3177 Leak Repair 1 LS $ 2,000.00 $ 2,000.00
Total Net Change = $6,906.00
Reason for Change Order:
Added Items:
CO.06.01 Through CO.06.03 = Added items to fix drainage issue north of Badger Mill Creek east of Ice Age Trail creek crossing.
Removed existing CMP culvert placed in the 1960’s that was plugged and damaged. Replaced with new pipe and endwalls and
area graded to drain to new pipe.
CO.05.15 = Added item to fix leak in existing MH SA3177. This was the existing manhole that the new ESI was connected to at
Bruce Street. Leak present in previously abandoned pipe penetration. Leak was causing a significant amount of groundwater to
enter the sanitary sewer system.
CONTRACT PRICE CONTRACT TIMES (Calendar Days)
To substantial To final
completion completion
Original: $7,761,804.60 Original Completion Date: 11/12/2021 11/19/2021
Previous C.O.s (ADD/DEDUCT): $288,893.50 Previous C.O.s (ADD/DEDUCT): N/A N/A
This C.O. (ADD/DEDUCT): $6,906.00 This C.O. (ADD/DEDUCT): N/A N/A
Contract Price with all REVISED: N/A N/A
approved Change Orders: $8,057,604.10
Revised Completion Date: N/A N/A
It is agreed by the Contractor that this Change Order includes any and all costs associated with or resulting from the change(s)
ordered herein, including all impact, delays, and acceleration costs. Other than the dollar amount and time allowance listed above,
there shall be no further time or dollar compensation as a result of this Change Order.
THIS DOCUMENT SHALL BECOME AN AMENDMENT TO THE CONTRACT AND ALL
STIPULATIONS AND COVENANTS OF THE CONTRACT SHALL APPLY HERETO.
Project Forms Page 1 / 2
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Digitally signed by Nelson, Theresa
Date: 2022.03.28 11:30:43 -05'00'
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P.O. BOX 236
PHONE: 952-368-9200 FAX: 952-368-9311
T&M Work Daily Billing Breakdown (Direct Costs)
Date: 3.18.22
Project: Verona Eastside Interceptor
Description of Extra Work: Estimate to move left over Trees From Dane County Work
Mobilize 245 2/23/22 - 2/24/22 - De-Mobilize
2/22/22 -
Excavator with Continue Finish Moving 245 Excavator
Begin Moving
Thumb & Moving Logs/Brush with Thumb &
Logs/Brush
Offroad Truck Logs/Brush Clean up Site Offroad Truck
Date:
Hourly Rate
(Straight
Labor Costs Time) Hours Hours Hours Hours Hours Hours Total Cost
$ -
Truck Driver $ 87.43 7.00 7.00 $ 1,224.02
Foreman - Tim P $ 113.79 11.00 11.00 11.00 $ 3,755.07
$ -
$ -
$ -
$ -
Total Labor Cost Without Markup $ 4,979.09
Labor Markup (15%) $ 746.86
Total Labor Cost With Markup $ 5,725.95
Equipment Costs
Lowboy Tractor Trailer $ 120.00 7.00 7.00 $ 1,680.00
245 Excavator $ 115.00 11.00 11.00 11.00 $ 3,795.00
30 Ton Off-Road Haul Truck $ 115.00 11.00 11.00 11.00 $ 3,795.00
Foreman Truck $ 30.00 11.00 11.00 11.00 $ 990.00
Cat 299 Skid Loader $ 47.00 5.00 $ 235.00
Total Equipment Cost Without Markup $ 10,495.00
Equipment Markup (15%) $ 1,574.25
Total Equipment Cost With Markup $ 12,069.25
Material Costs Quantity Unit Unit Price
$ -
$ -
$ -
$ -
$ -
Total Material Cost Without Markup $ -
Subcontractor Markup (15%) $ -
Total Material Cost With Markup $ -
Subcontractor Costs Quantity Unit Unit Price
$ -
$ -
Total Material Cost Without Markup $ -
Subcontractor Markup (5%) $ -
Total Material Cost With Markup $ -
Summary
Total Labor Cost $ 5,725.95
Total Equipment Cost $ 12,069.25
Total Material Cost $ -
Total Subcontractor Cost $ -
Total Cost of Extra Work $ 17,795.20
Submittal of Annual Reports and Other Compliance Documents for Municipal
Separate Storm Sewer System (MS4) Permits
NOTE: Missing or incomplete fields are highlighted at the bottom of each page. You may save, close and return to your draft permit as often as necessary to complete
your application. After 120 days your draft is deleted.
Form 3400-224(R8/2021)
Reporting Information :
Will you be completing the Annual Report or other submittal type? Annual Report Other
Project Name: 2021 Annual Report
County: Dane
Municipality: Verona City
Permit Number: S058416
Facility Number: 30911
Reporting Year: 2021
Is this submittal also satisfying an Urban Nonpoint Source Grant funded deliverable? Yes No
Required Attachments and Supplemental Information
Please complete the contents of each tab to submit your MS4 permit compliance document. The information
included in this checklist is necessary for a complete submittal. A complete and detailed submittal will help us
review about your MS4 permit document. To help us make a decision in the shortest amount of time possible, the
following information must be submitted:
Annual Report
Review related web site and instructions for Municipal storm water permit eReporting [Exit Form]
Complete all required fields on the annual report form and upload required attachments
Attach the following other supporting documents as appropriate using the attachments tab above
Public Education and Outreach Annual Report Summary
Public Involvement and Participation Annual Report Summary
Illicit Discharge Detection and Elimination Annual Report Summary
Construction Site Pollution Control Annual Report Summary
Post-Construction Storm Water Management Annual Report Summary
Pollution Prevention Annual Report Summary
Leaf and Yard Waste Management
Municipal Facility (BMP) Inspection Report
Municipal Property SWPPP
Municipally Property Inspection Report
Winter Road Maintenance
Storm Sewer Map Annual Report Attachment
Storm Water Quality Management Annual Report Attachment
TMDL Attachment
Storm Water Consortium/Group Report
Municipal Cooperation Attachment
Other Annual Report Attachment
Attach the following permit compliance documents as appropriate using the attachments tab above
Storm Water Management Program
Public Education and Outreach Program
Public Involvement and Participation Program
Illicit Discharge Detection and Elimination Program
Construction Site Pollutant Control Program
Post-Construction Storm Water Management Program
Pollution Prevention Program
Municipal Storm Water Management Facility (BMP) Inventory
Municipal Storm Water Management Facility (BMP) Inspection and Maintenance Plan
Total Maximum Daily Load documents (*If applicable, see permit for due dates.)
TMDL Mapping*
TMDL Modeling*
TMDL Implementation Plan*
Fecal Coliform Screening Parameter *
Fecal Coliform Inventory and Map (S050075-03 general permittees Appendix B B.5.2 – document due to the
department by March 31, 2022)
Fecal Coliform Source Elimination Plan (S050075-03 general permittees Appendix B - document due to the
department by October 31,2023)
Sign and Submit form
Form 3400-224 (R8/2021)
Municipal Contact Information- Complete
Notice: Pursuant to s. NR 216.07(8), Wis. Adm. Code, an owner or operator of a Municipal Separate Storm Sewer System (MS4) is
required to submit an annual report to the Department of Natural Resources (Department) by March 31 of each year to report on
activities for the previous calendar year (“reporting year”). This form is being provided by the Department for the user’s convenience for
reporting on activities undertaken in each reporting year of the permit term. Personal information collected will be used for
administrative purposes and may be provided to the extent required by Wisconsin’s Open Records Law [ss. 19.31-19.39, Wis. Stats.].
Note: Compliance items must be submitted using the Attachments tab.
Municipality Information
Name of Municipality Verona City
Facility ID # or (FIN): 30911
Check to update mailing address information
Updated Information:
Mailing Address: 111 Lincoln St
Mailing Address 2:
City: Verona
State: Wisconsin
Zip Code: 53593 xxxxx or xxxxx-xxxx
Primary Municipal Contact Person (Authorized Representative for MS4 Permit)
The “Authorized Representative” or “Authorized Municipal Contact” includes the municipal official that was
charged with compliance and oversight of the permit conditions, and has signature authority for submitting
permit documents to the Department (i.e., Mayor, Municipal Administrator, Director of Public Works, City
Engineer).
Select to create new primary contact
First Name: Theran
Last Name: Jacobson
Select to update current contact information
Title: Director of Public Works
Mailing Address: 410 Investment Ct
Mailing Address 2:
City: Verona
State: WI
Zip Code: 53593 xxxxx or xxxxx-xxxx
Phone Number: 608-845-6695 Ext: xxx-xxx-xxxx
Email: theran.jacobson@ci.verona.wi.us
Additional Contacts Information (Optional)
I&E Program
IDDE Program
IDDE Response Procedure Manual
Municipal-wide Water Quality Plan
Individual with responsibility for: Ordinances
(Check all that apply) Pollution Prevention Program
Post-Construction Program
Winter roadway maintenance
First Name: Brian
Last Name: Peterson
Title: Str. Superintendent
Mailing Address: 410 Investment Court
Mailing Address 2:
City: Verona
State: WI
Zip Code: 53593 xxxxx or xxxxx-xxxx
Phone Number: 608-845-6695 Ext: xxx-xxx-xxxx
Email: brian.peterson@ci.verona.wi.us
I&E Program
IDDE Program
IDDE Response Procedure Manual
Individual with responsibility for: Municipal-wide Water Quality Plan
(Check all that apply) Ordinances
Pollution Prevention Program
Post-Construction Program
Winter roadway maintenance
First Name: Carla
Last Name: Fischer
Title: City Engineer
Mailing Address: 1350 Deming Way
Mailing Address 2: Ste 100
City: Middleton
State: WI
Zip Code: 53562 xxxxx or xxxxx-xxxx
Phone Number: 603-828-8128 Ext: xxx-xxx-xxxx
Email: carla.fischer@aecom.com
I&E Program
IDDE Program
IDDE Response Procedure Manual
Municipal-wide Water Quality Plan
Individual with responsibility for: Ordinances
(Check all that apply) Pollution Prevention Program
Post-Construction Program
Winter roadway maintenance
First Name: Kyle
Last Name: Neeve
Title: Engineer
Mailing Address: 1350 Deming Way
Mailing Address 2: Ste 100
City: Middleton
State: WI
Zip Code: 53562 xxxxx or xxxxx-xxxx
Phone Number: 608-828-8172 Ext: xxx-xxx-xxxx
Email: kyle.neeve@aecom.com
1. Does the municipality rely on another entity to satisfy some of the permit requirements?
Yes No
Public Education and Outreach Madison Area Storm Water Partnership (MAMSWaP)
Public Involvement and Participation MAMSWaP
Illicit Discharge Detection and Elimination AECOM
Construction Site Pollutant Control AECOM
Post-Construction Storm Water Management AECOM
Pollution Prevention
2. Has there been any changes to the municipality’s participation in group efforts towards permit compliances (i.e.,
the municipality has added or dropped consortium membership)?
Yes No
Form 3400-224 (R8/2021)
Minimum Control Measures- Section 1 : Complete
1. Public Education and Outreach
a. Complete the following information on Public Education and Outreach Activities related to storm
water. Select the Delivery Mechanism that best describes how the topics were conveyed to your
population. Use the Add Event to add additional entries.
Event Start Date 1/12/2021
Project/Event Name Where Does Verona's Water Come From and Where Does It Go
Delivery Mechanism Educational activity* *Active
Estimated People Regional Effort
Topics Covered Target Audience
Reached (Optional) (Optional)
Illicit discharge detection and elimination General Public 1 - 10 Yes No
Household hazardous waste disposal/pet Public Employees
waste management/vehicle washing Residents
Yard waste management/pesticide and Businesses
fertilizer application
Contractors
Stream and shoreline management
Developers
Residential infiltration
Industries
Construction sites and post-construction
Other
storm water management
Pollution prevention
Green infrastructure/low impact
development
Other:
Event Start Date 2/2/2021
Project/Event Name Verona's Storm Water Quality
Delivery Mechanism Educational activity* *Active
Estimated People Regional Effort
Topics Covered Target Audience
Reached (Optional) (Optional)
Illicit discharge detection and elimination General Public 1 - 10 Yes No
Household hazardous waste disposal/pet Public Employees
waste management/vehicle washing Residents
Yard waste management/pesticide and Businesses
fertilizer application
Contractors
Stream and shoreline management
Developers
Residential infiltration
Industries
Construction sites and post-construction
Other
storm water management
Pollution prevention
Green infrastructure/low impact
development
Other:
Event Start Date 3/23/2021
Project/Event Name Stormwater Basin Management Strategies
Delivery Mechanism Educational activity* *Active
Estimated People Regional Effort
Topics Covered Target Audience
Reached (Optional) (Optional)
Illicit discharge detection and elimination General Public 1 - 10 Yes No
Household hazardous waste disposal/pet Public Employees
waste management/vehicle washing Residents
Yard waste management/pesticide and Businesses
fertilizer application
Contractors
Stream and shoreline management
Developers
Residential infiltration
Industries
Construction sites and post-construction
Other
storm water management
Pollution prevention
Green infrastructure/low impact
development
Other:
Event Start Date 4/13/2021
Project/Event Name The Lincoln Street Basin
Delivery Mechanism Educational activity* *Active
Estimated People Regional Effort
Topics Covered Target Audience
Reached (Optional) (Optional)
Illicit discharge detection and elimination General Public 1 - 10 Yes No
Household hazardous waste disposal/pet Public Employees
waste management/vehicle washing Residents
Yard waste management/pesticide and Businesses
fertilizer application
Contractors
Stream and shoreline management
Developers
Residential infiltration
Industries
Construction sites and post-construction
Other
storm water management
Pollution prevention
Green infrastructure/low impact
development
Other:
Event Start Date 4/26/2021
Project/Event Name Storm Water Pond Treatment
Delivery Mechanism Educational activity* *Active
Estimated People Regional Effort
Topics Covered Target Audience
Reached (Optional) (Optional)
Illicit discharge detection and elimination General Public 1 - 10 Yes No
Household hazardous waste disposal/pet Public Employees
waste management/vehicle washing Residents
Yard waste management/pesticide and Businesses
fertilizer application
Contractors
Stream and shoreline management
Residential infiltration Developers
Construction sites and post-construction Industries
storm water management Other
Pollution prevention
Green infrastructure/low impact
development
Other:
Event Start Date 9/21/2021
Project/Event Name 23 Prairie Oaks Detention Basin Clean-Out Project
Delivery Mechanism Educational activity* *Active
Estimated People Regional Effort
Topics Covered Target Audience
Reached (Optional) (Optional)
Illicit discharge detection and elimination General Public 1 - 10 Yes No
Household hazardous waste disposal/pet Public Employees
waste management/vehicle washing Residents
Yard waste management/pesticide and Businesses
fertilizer application
Contractors
Stream and shoreline management
Developers
Residential infiltration
Industries
Construction sites and post-construction
Other
storm water management
Pollution prevention
Green infrastructure/low impact
development
Other:
Event Start Date 10/5/2021
Project/Event Name Using Alum Flocculants to Treat Strom Water Ponds to Control Phosphorous
Delivery Mechanism Educational activity* *Active
Estimated People Regional Effort
Topics Covered Target Audience
Reached (Optional) (Optional)
Illicit discharge detection and elimination General Public 1 - 10 Yes No
Household hazardous waste disposal/pet Public Employees
waste management/vehicle washing Residents
Yard waste management/pesticide and Businesses
fertilizer application
Contractors
Stream and shoreline management
Developers
Residential infiltration
Industries
Construction sites and post-construction
Other
storm water management
Pollution prevention
Green infrastructure/low impact
development
Other:
Event Start Date 12/14/2021
Project/Event Name How is storm water different from our drinking water and wastewater
Delivery Mechanism Educational activity* *Active
Estimated People Regional Effort
Topics Covered Target Audience
Reached (Optional) (Optional)
Illicit discharge detection and elimination General Public 1 - 10 Yes No
Household hazardous waste disposal/pet Public Employees
waste management/vehicle washing Residents
Yard waste management/pesticide and Businesses
fertilizer application
Contractors
Stream and shoreline management
Developers
Residential infiltration
Industries
Construction sites and post-construction
Other
storm water management
Pollution prevention
Green infrastructure/low impact
development
Other:
place holder
b. Brief explanation on Public Education and Outreach reporting. Limit response to 250 characters
and/or attach supplemental information on the attachments page.
See Public Education & Outreach 2021 Summary for details (attachment). Each of the
event presentation is included in the attachments.
Form 3400-224 (R8/2021)
Minimum Control Measures - Section 2 : Complete
2. Public Involvement and Participation
a. Permit Activities. Complete the following information on Public Involvement and Participation
Activities related to storm water. Select the Delivery Mechanism that best describes how the permit
activities were conveyed to your population. Use the Add Event to add additional entries.
Event Start Date 2/22/2021
Project/Event Name City Council Meetings
Delivery Mechanism Government Event (Public Hearing, Council Meeting, etc)
Estimated People Regional Effort
Topics Covered Target Audience
Reached (Optional) (Optional)
MS4 Annual Report General Public 1 - 10 Yes No
Storm Water Management Program Public Employees
Storm Water related ordinance Residents
Other: Businesses
Contractors
Developers
Industries
Other
Event Start Date 4/7/2021
Project/Event Name Plan Commission meetings
Delivery Mechanism Government Event (Public Hearing, Council Meeting, etc)
Estimated People Regional Effort
Topics Covered Target Audience
Reached (Optional) (Optional)
MS4 Annual Report General Public 1 - 10 Yes No
Storm Water Management Program Public Employees
Storm Water related ordinance Residents
Other: Businesses
Contractors
Developers
Industries
Other
Event Start Date 1/11/2021
Project/Event Name Public Works Committee Meetings
Delivery Mechanism Government Event (Public Hearing, Council Meeting, etc)
Estimated People Regional Effort
Topics Covered Target Audience
Reached (Optional) (Optional)
MS4 Annual Report General Public 1 - 10 Yes No
Storm Water Management Program Public Employees
Storm Water related ordinance Residents
Other: Businesses
Contractors
Developers
Industries
Other
b. Volunteer Activities. Complete the following information on Public Involvement and Participation
Activities related to storm water. Select the Delivery Mechanism that best describes how volunteer
activities were conveyed to your population. Use the Add Event to add additional entries.
Event Start Date 1/23/2021 NA (Individual Permittee).
Project/Event Name Sugar River Wetlands Restoration Days
Delivery Mechanism Other hands-on event
Estimated People Regional Effort
Topics Covered Target Audience
Reached (Optional) (Optional)
11-50 Yes No
Volunteer Opportunity General Public
Public Employees
Residents
Businesses
Contractors
Developers
Industries
Other
c. Brief explanation on Public Involvement and Participation reporting. Limit response
to 250 characters and/or attach supplemental information on the attachments page.
A summary of Verona’s Public Involvement and Participation is included as an attachment. The
agendas and minutes for the Public Works Committee, Common Council, and Plan Commission
meetings are included as attachments.
Form 3400-224 (R8/2021)
Minimum Control Measures - Section 3 : Complete
3. Illicit Discharge Detection and Elimination
a. How many total outfalls does the municipality have? Unsure
15
b. How many outfalls did the municipality evaluate as part Unsure
10
of their routine ongoing field screening program?
c. From the municipality's routine screening, how many Unsure
0
were confirmed illicit discharges?
d. How many illicit discharge complaints did the Unsure
0
municipality receive?
e. From the complaints received, how many were Unsure
0
confirmed illicit discharges?
f. How many of the identified illicit discharges did the Unsure
0
municipality eliminate in the reporting year (from both
routine screening and complaints)?
(If the sum of 3.c. and 3.e. does not equal 3.f., please explain below.)
g. How many of the following enforcement mechanisms did the municipality Unsure
use to enforce its illicit discharge ordinance? Check all that apply and
enter the number of each used in the reporting year.
Verbal Warning 0
Written Warning (including email) 0
Notice of Violation 0
Civil Penalty/ Citation 0
Additional Information:
h. Brief explanation on Illicit Discharge Detection and Elimination reporting. If you
marked Unsure for any questions above, justify the reasoning. Limit response to
250 characters and/or attach supplemental information on the attachments page.
Verona's consultant AECOM performs annual dry weather monitoring to check for Illicit Discharge, see
attachment for the reports AECOM prepared in 2021.
Form 3400-224 (R8/2021)
Minimum Control Measures - Section 4 : Complete
4. Construction Site Pollutant Control
a. How many total construction sites with one acre or more Unsure
20
of land disturbing construction activity were active at any
point in the reporting year?
b. How many construction sites with one acre or more of Unsure
19
land disturbing construction activity did the municipality
issue permits for in the reporting year?
c. How many erosion control inspections did the municipality Unsure
57
complete in the reporting year (at sites with one acre or
more of land disturbing construction activity)?
d. What types of enforcement actions does the municipality have available Unsure
to compel compliance with the regulatory mechanism? Check all that
apply and enter the number of each used in the reporting year.
No Authority
Verbal Warning 2
Written Warning (including email) 8
Notice of Violation 0
Civil Penalty/ Citation 0
Stop Work Order 0
Forfeiture of Deposit
Other - Describe below
e. Brief explanation on Construction Site Pollutant Control reporting . If you marked
Unsure for any questions above, justify the reasoning. Limit response to 250 characters
and/or attach supplemental information on the attachments page.
A summary of Construction Site Pollutant Control activities is included as an attachment. The sites
inspected during 2021 are listed in the attachment.
Form 3400-224 (R8/2021)
Minimum Control Measures - Section 5 : Complete
5. Post-Construction Storm Water Management
a. How many sites with new structural storm water Unsure
9
management facilities* have received local approval ?
*Engineered and constructed systems that are designed to provide storm water
quality control such as wet detention ponds, constructed wetlands, infiltration
basins, grassed swales, permeable pavement, catch basin sumps, etc.
b. Does the permittee have procedures for inspecting and Yes No Unsure
maintaining private storm water facilities?
c. If Yes, how many privately owned storm water Unsure
26
management facilities were inspected in the reporting year ?
Inspections completed by private landowners should be included in the reported
number.
d. What types of enforcement actions does the municipality have available Unsure
to compel compliance with the regulatory mechanism? Check all that
apply and enter the number of each used in the reporting year.
No Authority
Verbal Warning 0
Written Warning (including email) 0
Notice of Violation 0
Civil Penalty/ Citation
Forfeiture of Deposit
Complete Maintenance
Bill Responsible Party
Other - Describe below
e. Brief explanation on Post-Construction Storm Water Management reporting . If
marked 'Unsure' on any questions above, justify your reasoning. Limit your response to
250 characters and/or attach supplemental information on the attachments page.
A summary of the private storm water sites inspected during 2021 is included as an attachment.
Form 3400-224 (R8/2021)
Minimum Control Measures - Section 6 : Complete
6. Pollution Prevention
Storm Water Management Facility Inspections Not Applicable
a. Enter the total number of municipally owned or operated Unsure
60
structural storm water management facilities ?
b. How many new municipally owned storm water management Unsure
0
facilities were installed in the reporting year ?
c. How many municipally owned storm water management facilities Unsure
50
were inspected in the reporting year?
d. What elements are looked at during inspections (250 character
limit)?
Vegetation, discharge structures, inflow structures, basins are photographed from set
locations
e. How many of these facilities required maintenance? Unsure
10
f. Brief explanation on Storm Water Management Facility inspection
reporting. If you marked Unsure for any questions above, justify the
reasoning. Limit response to 250 characters and/or attach supplemental
information on the attachments page.
Public Works Yards & Other Municipally Owned Properties (SWPPP Plan Review) Not Applicable
g. How many municipal properties require a SWPPP? Unsure
3
h. How many inspections of municipal properties have been Unsure
3
conducted in the reporting year?
i. Have amendments to the SWPPPs been made?
Yes No Unsure
j. If yes, describe what changes have been made. Limit response to 250 characters
and/or attach supplemental information on the attachment page:
k. Brief explanation on Storm Water Pollution Prevention Plan reporting. If you marked
Unsure for any questions above, justify the reasoning. Limit response to 250
characters and/or attach supplemental information on the attachments page.
Collection Services - Street Sweeping / Cleaning Program Not Applicable
l. Did the municipality conduct street sweeping/cleaning during the reporting year?
Yes No Unsure
m. If known, how many tons of material was removed? Unsure
813
n. Does the municipality have a low hazard exemption for this Yes No
material?
o. If street cleaning is identified as a storm water best management practice in the
pollutant loading analysis, was street cleaning completed at the assumed frequency?
Yes - Explain frequency
No - Explain
Not Applicable
Collection Services - Catch Basin Sump Cleaning Program Not Applicable
p. Did the municipality conduct catch basin sump cleaning during the reporting
year? Yes No Unsure
q. How many catch basin sumps were cleaned in the reporting year? 12 Unsure
r. If known, how many tons of material was collected? Unsure
s. Does the municipality have a low hazard exemption for this Yes No
material?
t. If catch basin sump cleaning is identified as a storm water best management practice
in the pollutant loading analysis, was cleaning completed at the assumed frequency?
Yes- Explain frequency
No - Explain
Not Applicable
Collection Services - Leaf Collection Program Not Applicable
u. Does the municipality conduct curbside leaf collection? Yes No Unsure
v. Does the municipality notify homeowners about pickup? Yes No Unsure
w. Where are the residents directed to store the leaves for collection?
Pile on terrace Pile in street Bags on terrace Unsure
Other - Describe
x. What is the frequency of collection?
bi-weekly during the growing season &
weekly during the fall
y. Is collection followed by street sweeping/cleaning? Yes No Unsure
z. Brief explanation on Collection Services reporting. If you
marked Unsure for any questions above, justify the
reasoning. Limit response to 250 characters and/or attach
supplemental information on the attachments page
Winter Road Management Not Applicable
*Note: We are requesting information that goes beyond the reporting year, answer the best you can.
aa. How many lane-miles of roadway is the municipality 71 Unsure
responsible for doing snow and ice control?
ab. Provide amount of de-icing products used by month last winter season?
Solids (tons) (ex. sand, or salt-sand)
Product Oct Nov Dec Jan Feb Mar
Salt 0 0 260 450 230 450
Liquids (gallons) (ex. brine)
Oct Nov Dec Jan Feb Mar
Brine 0 0 2875 1775 3150 0
ac. Was salt applying machinery calibrated in the reporting Yes No Unsure
year?
ad. Have municipal personnel attended salt reduction strategy Yes No Unsure
training in the reporting year?
Training Date Training Name # Attendance
10/6/2021 "Brine 101" By Be Salt Wise 20
ae. Brief explanation on Winter Road Management reporting. If you marked Unsure for any
questions above, justify the reasoning. Limit response to 250 characters and/or attach
supplemental information on the attachments page
Training went over how to incorporate salt brine into winter maintenance.
Internal (Staff) Education & Communication
af. Has training or education been held for municipal or other Yes No Unsure
personnel involved in implementing each of the pollution
prevention program elements ?
If yes, describe what training was provided (250 character limit):
When:
How many attended:
ag. Describe how the municipality has kept the following local officials and municipal
staff aware of the municipal storm water discharge permit programs and its
requirements.
Elected Officials
Public Works Committee meetings, City Council meetings, Plan Commission
meetings
Municipal Officials
Technical Review Committee meetings - provide recommendations to Plan
Commission
Appropriate Staff ( such as operators, Department heads, and those that interact
with public)
Staff Meetings
ah. Brief explanation on Internal Education reporting. If you marked Unsure for any
questions above, justify the reasoning. Limit response to 250 characters and/or
attach supplemental information on the attachments page.
Form 3400-224 (R8/2021)
Minimum Control Measures - Section 7 : Complete
7. Storm Sewer System Map
a. Did the municipality update their storm sewer map this year?
Yes No Unsure
If yes, check the areas the map items that got updated or changed:
Storm water treatment facilities
Storm pipes
Vegetated swales
Outfalls
Other - Describe below
b. Brief explanation on Storm Sewer System Map reporting. If you marked Unsure for an
question for any questions above, justify the reasoning. Limit response to
250 characters and/or attach supplemental information on the attachments page.
Storm Sewer map is included as an attachment
Form 3400-224 (R8/2021)
Final Evaluation - Complete
Fiscal Analysis
Complete the fiscal analysis table provided below. For municipalities that do not break out funding
into permit program elements, please enter the monetary amount to your best estimate of what
funding may be going towards these programs.
Annual Budget Budget Source of Funds
Expenditure Reporting Year Upcoming
Reporting Year Year
Element: Public Education and Outreach
15019 17100 17200 Storm water utility
Element: Public Involvement and Participation
828 1300 1500 Storm water utility
Element: Illicit Discharge Detection and Elimination
5766 3900 4000 Storm water utility
Element: Construction Site Pollutant Control
31756 7900 40600 Storm water utility
Element: Post-Construction Storm Water Management
136135 12500 140000 Permit fee and/or deposit/escrow
Element: Pollution Prevention
419238 494200 495000 Storm water utility
Other (describe)
Storm Sewer System Map
5870 12000 12000 Storm water utility
Other (describe)
Storm Water Quality Management
13517 10250 2500 Storm water utility
Other (describe)
Basin Maintenance (vegetation burns & pond treatments)
41251 0 13000 Storm water utility
Please provide a justification for a "0" entered in the Fiscal Analysis. Limit response to 250 characters.
Water Quality
a: Were there any known water quality improvements in the receiving waters to which the
municipality’s storm sewer system directly discharges to?
Yes No Unsure If Yes, explain below:
b : Were there any known water quality degradation in the receiving waters to which the
municipality’s storm sewer system directly discharges to?
Yes No Unsure If Yes, explain below:
c: Have any of the receiving waters that the municipality discharges to been added to the impaired
waters list during the reporting year?
Yes No Unsure
d: Has the municipality evaluated their storm water practices to reduce the pollutants of concern?
Yes No Unsure
Storm Water Quality Management
a. Has the municipality completed or updated modeling in the reporting year (relating to developed
urban area performance standards of s. NR 151.13(2)(b)1., Wis. Adm. Code)? Yes No
b. If yes, enter percent reduction in the annual average mass discharging from the entire MS4 to
surface waters of the state as compared to implementing no storm water management controls:
Total suspended solids (TSS)
Total phosphorus (TP)
Additional Information
Based on the municipality’s storm water program evaluation, describe any proposed changes to the
municipality’s storm water program. If your response exceeds the 250 character limit, attach
supplemental information on the attachments page.
Form 3400-224 (R8/2021)
Requests for Assistance on Understanding Permit Programs
Would the municipality like the Department to contact them about providing more information on
understanding any of the Municipal Separate Storm Sewer Permit programs?
Please select all that apply:
Public Education and Outreach
Public Involvement and Participation
Illicit Discharge Detection and Elimination
Construction Site Pollutant Control
Post-Construction Storm Water Management
Pollution Prevention
Storm Water Quality Management
Storm Sewer System Map
Water Quality Concerns
Compliance Schedule Items Due
MS4 Program Evaluation
Form 3400-224(R8/2021)
Required Attachments and Supplemental Information
Any other MS4 program information for inclusion in the Annual Report may be attached on here. Use
the Add Additional Attachments to add multiple documents.
Upload Required Attachments (15 MB per file limit) - Help reduce file size and trouble shoot file uploads
*Required Item
Note: To replace an existing file, use the 'Click here to attach file ' link or press the to delete an item.
Storm Sewer System Map
Verona_MAMSWaP_2021.pdf
File Attachment
Attach - Other Supporting Documents
AR_EO
PublicEducationandOutreach2021Summary.pdf
File Attachment
AR_EO
01VeronawaterresourceJanuary2021.pdf
File Attachment
AR_EO
02VeronaStormWaterQuality02-02-2021.pdf
File Attachment
AR_EO
03BasinManagementStrategiesMarch232021.pdf
File Attachment
AR_EO
04StormWaterBasinVegetaionBurnsMarch-Apirl2021.pdf
File Attachment
AR_EO
05LincolnStBasin04-13-2021.pdf
File Attachment
AR_EO
06StormWaterPondTreatmentApril262021.pdf
File Attachment
AR_EO
0723PrairieOaksClean-outSept2021.pdf
File Attachment
AR_EO
08UsingAlumFlocculantsupdatedfromOctober52021.pdf
File Attachment
AR_EO
09VeronawaterresourceNovember2021.pdf
File Attachment
AR_EO
10StormWaterBasicsDecember2021.pdf
File Attachment
AR_IP
PublicInvolvementandParticipation2021Summarry.pdf
File Attachment
AR_IP
2021PublicWorksMinuteswstormwater.pdf
File Attachment
AR_IP
2021CommonCouncilMinuteswithStormWater.pdf
File Attachment
AR_IDDE
IllicitDischargeDetectionElimination2021Summary.pdf
File Attachment
AR_CSPC
ConstructionSiteErosionControl2021Summary.pdf
File Attachment
AR_PCSSW
Post-ConstructionStormWaterManagement2021Summary.pdf
File Attachment
AR_PP
PollutionPrevention2021Summary.pdf
File Attachment
AR_PP
StreetSweeping2021Summary.pdf
File Attachment
AR_LeafYardMgmt
LeafYardWasteCollection2021Summary.pdf
File Attachment
AR_Other
MAMSWaP_Notes.pdf
File Attachment
AR_IP
2021PlanCommissionMinutes.pdf
File Attachment
AR_IP
2021CommonCouncilAgendas.pdf
File Attachment
AR_IP
PWSW2021Agenda.pdf
File Attachment
AR_SWQM
StormWaterQualityManagementReport.pdf
File Attachment
AR_SWQM
StormWaterQualityManagementReportSummary.pdf
File Attachment
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Attach - Permit Compliance Documents
EO_Program
2021-IE-Work-Plan-FINAL.pdf
File Attachment
PCSSW_Program
CityofVeronaSWPPP_Combined_reduced.pdf
File Attachment
IDDE_Program
Verona_IDDE_Plan.pdf
File Attachment
IP_Program
PublicInvolvementandParticipationPlan2021.pdf
File Attachment
PP_BMPInventory
BasinMaintenancePlan2022-2025.pdf
File Attachment
CS_Program
ConstructionSitePollutantControl.pdf
File Attachment
PCSSW_Program
PostConstructionStormWaterManagement.pdf
File Attachment
EO_Program
IE-WPDES-2022AnnualWorkPlan_22_03_30.pdf
File Attachment
PP_BMPInventory
VeronaSWBasins2021-December2021.pdf
File Attachment
EO_Program
PublicEducationandOutreachPlan2021.pdf
File Attachment
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Form 3400-224(R8/2021)
Sign and Submit Your Application
Steps to Complete the signature process
1. Read and Accept the Terms and Conditions
2. Press the Submit and Send to the DNR button
NOTE: For security purposes all email correspondence will be sent to the address you used when
registering your WAMS ID. This may be a different email than that provided in the application. For
information on your WAMS account click HERE .
Terms and Conditions
Certification: I hereby certify that I am an authorized representative of the municipality covered
under Verona City MS4 Permit for which this annual report or other compliance document is being
submitted, and that the information contained in this submittal and all attachments were gathered
and prepared under my direction or supervision. Based on my inquiry of the person or persons under
my direction or supervision involved in the preparation of this document, to the best of my
knowledge, the information is true, accurate, and complete. I further certify that the municipality’s
governing body or delegated representatives have reviewed or been apprised of the contents of this
annual report. I understand that Wisconsin law provides severe penalties for submitting false
information.
Signee (must check current role prior to accepting terms and conditions)
Authorized municipal contact using WAMS ID.
Delegation of Signature Authority ( Form 3400-220 ) for agent signing on the behalf of the
authorized municipal contact.
Agent seeking to share this item with authorized municipal contact (authorized municipal
contact must get WAMS id and complete signature).
Name: Theran Jacobson
Title: Director of Public Works
Authorized Signature. Signed by : i:0#.f|wamsmembership|theran5veronadpw on 2022-03-31T08:19:34
I accept the above You have already signed and submitted this application to the DNR. Please contact
terms and conditions. the Wisconsin DNR for assistance.
After providing the final authorized signature, the system will send an email to the authorized party and any agents. This email will
include a copy to the final read only version of this application.
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