As a result of a sustained drought in the Southwestern United States, and in order to maintain existing water capacity in the Las Vegas Valley, the Southern Nevada Water Authority constructed a new deep-water intake (Intake No. 3) located in Lake Mead. The project included a 185 m deep shaft, 4.7 km tunnel under very difficult geological conditions, and marine works for a submerged intake. This paper presents the experience that was gained during the design and construction and the innovative solutions that were developed to handle the difficult conditions that were encountered during tunneling with a dual-mode slurry tunnel-boring machine (TBM) in up to 15 bar (1 bar = 10⁵ Pa) pressure. Specific attention is given to the main challenges that were overcome during the TBM excavation, which included the mode of operation, face support pressures, pre-excavation grouting, and maintenance; to the construction of the intake, which involved deep underwater shaft excavation with blasting using shaped charges; to the construction of the innovative over 1200 t concrete-and-steel intake structure; to the placement of the intake structure in the underwater shaft; and to the docking and connection to an intake tunnel excavated by hybrid TBM.