CM-2017-1517 - 10/27/2017Agent Authorization Form
For Required Signature
Edwards Aquifer Protection Program
Relating to 30 TAC Chapter 213
Effective June 1, 1999
I Laurie Hadley
Print Name
City Manager
Title - Owner/President/Other
of City of Round Rock, Texas
Corporation/Partnership/Entity Name
have authorized
Daniel Franz, P.E., ct
Print Name of Agent/Engineer
of Halff Associates Inc.
Print Name of Firm
to represent and act on the behalf of the above named Corporation, Partnership, or Entity for
the purpose of preparing and submitting this plan application to the Texas Commission on
Environmental Quality (TCEQ) for the review and approval consideration of regulated
activities.
also understand that:
The applicant is responsible for compliance with 30 Texas Administrative Code
Chapter 213 and any condition of the TCEQ's approval letter. The TCEQ is authorized
to assess administrative penalties of up to $10,000 per day per violation.
2. For those submitting an application who are not the property owner, but who have the
right to control and possess the property, additional authorization is required from the
owner.
3. Application fees are due and payable at the time the application is submitted. The
application fee must be sent to the TCEQ cashier or to the appropriate regional office.
The application will not be considered until the correct fee is received by the
commission.
4. A notarized copy of the Agent Authorization Form must be provided for the person
preparing the application, and this form must accompany the completed application.
5. No person shall commence any regulated activity on the Edwards Aquifer Recharge
Zone, Contributing Zone or Transition Zone until the appropriate application for the
activity has been filed with and approved by the Executive Director.
CM -2 b / 7 -^ I517
TCEQ-0599 (Rev.04/01/2010)
Page 1 of 2
SIGNATURE PAGE:
b —7 /
Applica 's gijnature Date
-I—
THE STATE OF X §
County of K4III'd au� §
BEFORE ME, the undersigned authority, on this day personally appearedkk 167hq— known
to me to be the person whose name is subscribed to the foregoing instrument, and acknowledged to
me that (s)he executed same for the purpose and consideration therein expressed.
GIVEN under my hand and seal of office on this day of Ilaer , 211 -7
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76—Z=v—
ANCA GILLISNOTARY PUBLICublic, State of TexasExpires 03-15-2020
Notary ID 130582387
Typed or Printed Name of Notary
MY COMMISSION EXPIRES: �J�J 15 -202-0
TCEQ-0599 (Rev.04/01 /2010) Page 2 of 2
City of Round Rock
ROUND ROCK
TEXA5 Agenda Item Summary
Agenda Number:
Title: Consider executing TCEQ "Agent Authorization Form For Required
Signature Edwards Aquifer Projection Program Relating to 30 TAC Chapter
213" authorizing Daniel Franz to represent and act on behalf of the City
regarding the Texas Avenue Project.
Type: City Manager Item
Governing Body: City Manager Approval
Agenda Date: 10/27/2017
Dept Director: Gary D. Hudder, Transportation Director
Cost:
Indexes:
Attachments: 9_f-0599_agent_authorization_form.doc
Department: Transportation Department
Text of Legislative File CM -2017-1517
Consider executing TCEQ "Agent Authorization Form For Required Signature Edwards
Aquifer Projection Program Relating to 30 TAC Chapter 213" authorizing Daniel Franz to
represent and act on behalf of the City regarding the Texas Avenue Project.
The Texas Avenue Connection will extend existing Texas Avenue from Greenhill Drive to
its current termini, approximately 730 ft. east of Greenhill Drive. The Texas Avenue
Connection will provided continuity from Interstate 35 to the existing subdivisions east of
Greenhill Drive. The project is located within the Edwards Aquifer Recharge Zone and
requires approval from the Texas Commission on Environmental Quality (TCEQ).
TCEQ requires an Agent Authorization Form to allow someone other than the City
Manager to submit plan applications to the TCEQ for the review and approval of regulated
activities. The Transportation Department is requesting the City Manager to execute a
TCEQ "Agent Authorization Form For Required Signature Edwards Aquifer Projection
Program Relating to 30 TAC Chapter 213" authorizing Daniel Franz, P.E., cfm, of Halff
Associates, Inc., to represent and act on behalf of the City regarding the Texas Avenue
Project.
The Transportation Department recommends that the City of Round Rock execute the
City of Round Rock Page 1 Printed on 1012612017
r?
Agenda Item Summary Continued (CM -2017-1517)
attached Agent Authorization form which will
appoint Daniel Franz, P.E., as a City of Round Rock agent for the Texas Avenue
Connection.
City of Round Rock Page 2 Printed on 10/28/2017