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CM-10-02-052Texas Commission on Environmental Quality Edwards Aquifer Protection Program Application Fee Form NAME OF PROPOSED REGULATED ENTITY: City of Round Rock: Phase 2 - Southwest Downtown District Infrastructure Improvements- Main Street Between San Saba St. and Blair St. REGULATED ENTITY LOCATION: Main Street Between San Saba St. and Blair St. NAME OF CUSTOMER: City of Round Rock CONTACT PERSON: James C. Alvis, P.E. PHONE: 512-472-6721 FAX: 512-477-3211 Customer Reference Number (if issued): CN 600413181 (nine digits) Regulated Entity Reference Number (if issued): RN 102767100 (nine digits) Austin Regional Office (3373) 0 Hays San Antonio Regional Office (3362) ❑ Bexar O Travis ® Williamson ❑ Comai 0 Medina 0 Kinney 0 Uvalde Application fees must be paid by check, certified check, or money order, payable to the Texas Commission on Environmental Quality. Your canceled check will serve as your receipt. This form must be submitted with your fee payment. This payment is being submitted to (Check One): • Austin Regional Office O Mailed to TCEQ: TCEQ — Cashier Revenues Section Mail Code 214 P.O. Box 13088 Austin, TX 78711-3088 O San Antonio Regional Office O Overnight Delivery to TCEQ: TCEQ - Cashier 12100 Park 35 Circle Building A, 3rd Floor Austin, TX 78753 512/239-0347 Site Location (Check All That Apply): ® Recharge Zone ❑ Contributing Zone 0 Transition Zone Type of Plan Size Water Pollution Abatement Plan, Contributing Zone Plan: One Single Family Residential Dwelling Acres Fee Due Water Pollution Abatement Plan, Contributing Zone Plan: Multiple Single Family Residential and Parks Acres Water Pollution Abatement Plan, Contributing Zone Plan: Non-residential 4.24 Acres $ 4,000 Sewage Collection System Lift Stations without sewer lines $0.50/If min $650 1948 L.F. Underground or Aboveground Storage Tank Facility Acres Tanks $ 974 Piping System(s)(only) Exception Extension of Time es?. N.use, P.E.(' r If you have • - -stions on how to fill out this form or about the Edwards Aquifer protection program, please contact us at 210/490- 3096 for projects located in the San Antonio Region or 512/339-2929 for projects located in the Austin Region. TCEQ-0574 (Rev. 4/25/08) em10 ..-052_ c) "06-10 Date Each Each Each Page 1 of 2 Individuals are entitled to request and review their personal information that the agency gathers on its forms. They may also have any errors in their information corrected. To review such information, contact us at 512/239-3282. Texas Commission on Environmental Quality Edwards Aquifer Protection Program Application Fee Schedule 30 TAC Chapter 213 (effective 05/01/2008) Water Pollution Abatement Plans and Modifications Contributing Zone Plans and Modifications PROJECT PROJECT AREA IN ACRES FEE One Single Family Residential Dwelling <5 Multiple Single Family Residential and Parks <5 5 < 10 10 < 40 40<100 100 < 500 500 Non-residential (Commercial, industrial, institutional, multi -family residential, schools, and other sites where regulated activities will occur) <1 1<5 5<10 10<40 40 < 100 > 100 $650 $1,500 $3,000 $4,000 $6,500 $8,000 $10,000 $3,000 $4,000 $5,000 $6,500 $8,000 $10,000 Organized Sewage Collection Systems and Modifications PROJECT COST PER LINEAR FOOT MINIMUM FEE MAXIMUM FEE Sewage Collection Systems $0.50 $650 - $6,500 Underground and Aboveground Storage Tank System Facility Plans and Modifications PROJECT COST PER TANK OR PIPING MINIMUM FEE SYSTEM MAXIMUM FEE Underground and Aboveground Storage Tank Facility $650 Exception Requests $650 - $6,500 PROJECT FEE Exception Request $500 PROJECT Extension of Time Requests FEE Extension of Time Request $150 TCEQ-0574 (Rev. 4/25/08) Page 2 of 2 DATE: February 24, 2010 SUBJECT: City Manager Approval — February 26, 2010 ITEM: Consider executing TCEQ Edwards Aquifer Protection Program Application Fee for the Southwest Downtown District Infrastructure Improvements — Main Street between San Saba St. and Blair St. Project. Department: Transportation Services Staff Person: Thomas E. Word, P.E., Chief of Public Works Operations Justification: The City of Round Rock is extending Main Street between San Saba Street and Blair Street. A portion of this project will encroach on the Edward Aquifer. The TCEQ Edwards Aquifer Protection Program Application is required for water pollution abatement plan and sewage collection system. Strategic Plan Relevance: 26.0 Construct major elements of the transportation and mobility system as approved by Council in the Master Transportation Plan Funding: Cost: $4,974.00 Source of funds: 4B — Round Rock Transportation Development Corporation Construction Outside Resources (if applicable): TCEQ Page Southerland Page Public Comment (if applicable): N/A UPDATED APRIL 2008 10.19.09 Request for City CounciUCity Manager Action ® City Council ED City Manager Submit completed form for all City Manager and City Council approvals Department Name: Transportation Services Contact Person: Chaz Gordon / Kathy Michna Project Mgr/Resource: Todd Keltgen Project Coordinator Tom Word, P.E. Assigned Attorney: Stephan Sheets City Council or City Manager Approval Date: Agenda Wording Project Name: Southwet Downtown District Infrastructure ContractorNendor Texas Commission on Environmental Quality Funding Source: RR Trans Dev Corp Construction Additional funding Source: Amount: $ Account Number 2/26/2010 4,974.00 Consider executing TCEQ Edwards Aquifer Protection Program Applicaton Fee for the Southwest Downtown District Infrastructure Improvements - Main Street Between San Saba St. and Blair St. Project. Finance Information ED Is Funding Required? Yes re:11 No 17 Initial Construction Contract Construction Contract Amendment Change Order Change in Quantity Unforeseen Circumstances Initial Professional Services Agreement Supplemental Professional Service Agreement Purchasing/Service Agreement Purchase Order Item(s) to be purchased Other (Please clearly identify action below) TCEQ Edwards Aquifer Protection Program Application Fee Amount 4,974.00 FINANCE N/A Approved cj as CIo Finance/CIP Finance/Acct Purchasing Budget Date Date Date Date APPROVALS (to be completed ONLY by Finance) Approved qui 0 Finance Director Date Ice aper vas rave been obtained please forward the PFA, blue sheet. back up information aric originals to City Secretary, Sara White. ITEMS WILL NOT BE PLACED ijg THE (:cLot r i . AGENDA, h. DA ,/,; l r I I SFrNCE. AND LEGAL APPROVAL_. PRIOR TO SUBMISSION. Required for Submission of AL1. City Council and City Manager Items Project Mgr. Signature: Dept. Director Signature: *City Attorney Signatu City Manager Signature: Date: Date: Date: Date: d2•acp-D City Attorney signature is required for all items. REVISED 2/16/2010 LEGAL DEPARTMENT APPROVAL FOR CITY COUNCIL/CITY MANAGER ACTION Required for Submission of ALL City Council and City Manager Items Department Name: PW/Transportation Project Mgr/Resource: Todd Keltgen JCounci Action: I 1 ORDINANCE Agenda Wording Project Name: Southwest Downtown District Infrastructure Contractor/Vendor: Texas Commission on Environmental Quality a RESOLUTION City Manager Approval CMA Wording Consider executing TCEO Edwards Aquifer Protection Program Application Fee for the Southwest Downtown District Infrastructure Improvements - Main Street Between San Saba St. and Blair St. Project. Attorney Approval Attorney Notes/Comments 0:lwdox\SCCInts10199170931MISC100183280.XLS Updated 6/3108