CM-2023-229 - 10/6/2023Agent Authorization Form
For Required Signature
Edwards Aquifer Protection Program
Relating to 30 TAC Chapter 213
Effective June 1, 1999
have authorized Jen Henderson, P.E.
Print Name of Agent/Engineer
of Henderson Professional Engineers
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:
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.
CV- --:�r. -)--2-9
TCEQ-0599 (Rev.0410112010)
Page 1 of 2
SIGNATURE PAGE:
Date
THE STATE OF §
County of §
BEFORE ME, the undersigned authority, on this day personally appeared IL45 - a4known
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 Aay of � d�Y, oa.
"ACTARY PUB
err ^iti MONIQUE ADAMS I�
My Flofa♦y ID # 126257913 Typed or Printed N e of Notary
I.gbw March 22, 2026
MY COMMISSION EXPIRES:
TCEQ-0599 (Rev.04101I2010) Page 2 of 2
ROUND ROCK
YExao
City of Round Rock
Agenda Item Summary
Agenda Number:
Title: Consider executing "Agent Authorization Form For Required Signature Edwards
Aquifer Protection Program Relating to 30 TAC Chapter 213" authorizing Jen
Henderson of Henderson Professional Engineers to represent and act on behalf of
the City for the Behrens Ranch Trail Project.
Type: C ty Manager Item
Governing Body: City Manager Approval
Agenda Date: 10/6/2023
Dept Director: Rick Atkins, Parks and Recreation
Cost: $0.00
Indexes: General Se'f-Financed Construction
Attachments: IAF - Agent Authorization Form - TCEQ - (Jen Henderson) -Behrens Ranch Trail
Project, f-0599-age nt-authorization-form
Department: Parks & Recreation
Text of Legislative File CM-2023-229
This item authorizes the Jen Henderson to act on the City's behalf when submitting plans to TCEQ
requesting an exception to the requirements of the Edwards Aquifer rules. The construction activity
proposed in the park w-sll create a negligible increase in impervious cover so the exception request is
justified.
The Behrens Ranch Trail Project includes the construction of mountain bike trails throughout the park. The
City is currently working with WCID for approval of the plans. Since this project is over the aquifer,
additional permitting through TCEQ is also required.
City of Round Rock Page 1 of 1