CM-2022-122 - 5/27/2022Agent 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 Mana er ,
Title - Owner/President/Other
of the City of Round Rock ,
Corporation/Partnership/Entity Name
have authorized Katie Baker. PLA
me of Agentltngineer
of City of Round Rock, PARD
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.
I also understand that:
1. 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.
TCEQ-0599 (Rev.04/01/2010) Page i of 2
SIGNATURE PAGE:
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Applicant's Signature
THE STATE OF — &4�-§
County of r ��
5 21Zz
Date
BEFORE ME, the undersigned authority, on this day personally appearedknown
to me to be the person whose name is subscribed to the foregoing instrument, and acknovAedged to
me that (s)he executed same for the purpose and consideration therein expressed.
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GIVEN under my hand and seal of office on this day of �—' 2 -
Ino 4v�- k�
TARY PU 4IC
MOWMADAMS
My WvWy ID It 126267913
►.�;. " bpkn March 22, 2020
Typed or Printed Name of Notary
MY COMMISSION EXPIRES: z�
TCEQ-0599 (Rev.0410112010) Page 2 of 2
JrOR,Z'OUNO
ROCK
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City of Round Rock
Agenda Item Summary
Agenda Number:
Title: Consider executing "Agent Authorization Form For Requ red Signature Edwards
Aquifer Protection Program Re ating to 30 TAC
Chapter 213" authorizing Katie Baker of the City of Round Rock to represent and
act on behalf of the C ty for the Bowman Park Improvements Project,
Type: City Manager Item
Governing Body: City Manager Approva;
Agenda Date: 5/27/2022
Dept Director: Rick Atkins, Director
Cost: $0.00
Indexes: CDBG HUD Entitlement Grants
Attachments: tAF - Agent Authorization Form - TCEQ - (Katie Baker) - Bowman Park
Improvements
Department: Parks & Recreation
Text of Legislative File CM-2022-122
For City Manager approval
This item authorizes Katie Baker to act on behalf of the city for the Bowman Park Improvement Project
2022. Texas Commission on Environmental Quality (TCEQ) application. Bowman Park is located over the
Edwards Aquifer Recharge zone therefore approval from TCEQ is required prior to bidding and
construction.
Bowman Park improvement project includes:
1) Practice Field Turf Area
2) Turf and Tree Irrigation
3) Park Benches
4) Replacement of street side fence
5) Street Tree Planting
This item is funded through Community Development Block Grant.
City of Round Rock page 1 ,