Residential Turf Removal Program Application Part 1 - Rebate Reservation (Limited to one (1) rebate per property)

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Property Owner: Daytime Phone Number: Residential Turf Removal Program Application Part 1 - Rebate Reservation (Limited to one (1) rebate per property) Applicant Information (please print legibly) Contact Person (if different): Email: Mailing Address: City: State: Zip: Property Type: Project Information Total Lot Size: Single Family Home Duplex/Triplex/Fourplex Townhome Prperty Address: City: State: Zip: Water Agency (on your water bill): Water Service Account Number (MUST include a copy of a recent water bill): Estimate square footage in areas where turf is to be removed: Notes: Remember, front yards, areas visible from the street take precedence over backyards. Backyards will only be rebated if the front yard has already been to a drought tolerant landscape, and the existing street-visible turf is no more than 20% of the overall design. How is the turf irrigated now? Automatic sprinklers Manual sprinklers Hand watered Other What type of irrigation controller do you use? Model: Automatic controller Smart controller None Other Briefly describe your plan for the converted area (plants to be used, irrigation changes, etc. "Before" pictures must be included with this application-part 1): How do you plan to complete your project? Self Contractor Other Disclaimer Metropolitan and the participating water agencies make no representation or warranty relating to contracted services or products that may be installed in converted areas, including any hazardous substances that may be contained in the product. Removal of turf and installation of water efficient devices does not guarantee reduced water use. This application is for a rebate only as outlined in the Guidelines. By participating in the program, you waive and release Metropolitan, participating water agencies, and their contractors and agents from any and all claims and causes of acton arising out of the removal of turf and/or the purchase, installation or use of devices in connection with this Turf Removal rebate program. Any claim you may have based upon any defect or failure of performance of a contracted service or device purchased by you should be pursued with the contractor or manufacturer/distributor. Metropolitan and participating water agencies only enforce the terms and conditions of the Residential Turf Removal Program. The applicant is responsible for complying with all applicable laws, codes, policies, covenants, conditions, and restrictions that may apply. Quality and appearance of the converted area is the responsibility of the applicant. This is a voluntary program. Rebates will only be provided if all of the conditions and terms have been met. Funding for the program may run out at any time. Submitting a rebate application does NOT guarantee a rebate. If the project is not completed by the date given with the "Rebate Number" upon approval to move forward, you forfeit your rebate. Final project information (Part 2) must be RECEIVED complete on or before the deadline date. Final project information received more than five (5) days after the deadline date, will be returned to the applicant and rebate will NOT be honored. Signature (required) By signing below, the applicant agrees to comply with the program terms and conditions, as well as all the Federal, State and local codes, including covenants, conditions and restrictions, as applicable. The applicant has read, understands and agrees to the terms and conditions of the program as outlined and certifies that the information on the application is true and correct. Property Owner Signature: Print Name: Date: Please mail completed application to: Golden State Water Company Conservation Department, 1920 West Corporate, Anaheim, CA 92805. For more information, please call 1-888-774-2611

Residential Turf Removal Program Application Part 1 Rebate Reservation (Limited to one (1) rebate per property) DID YOU REMEMBER TO INCLUDE THE FOLLOWING WITH YOUR PART 1 APPLICATION? Recent photos of property you plan on converting Labels/titles of photos (please write ON the pictures) Recent Water Bill Completed Part 1 Application with Signature You must complete your project by the deadline date given. If you receive a Rebate Number and deadline date and do not believe you can meet that deadline, call us to see what can be done. It may be necessary to put your project "on hold" until further funding is approved for this program.

Residential Turf Removal Program Application Part 2 Rebate Request (Submit when project is COMPLETE) REBATE # Property Owner: Applicant Information (please print) Contact Person (if different): Daytime Phone Number: Email: Mailing Address: City: State: Zip: Property Address: City: State: Zip: Water Agency (on your water bill): Water Service Account Number (MUST include a copy of a recent water bill): Square Footage of Turf REMOVED: Notes: Where was turf removed from? Front Yard Side Yard Parkway/Easement Other How is the area irrigated now? Automatic sprinklers Manual sprinklers Hand watered Other What type of irrigation controller do you use now it is new or did you use existing? New Model Automatic controller Smart controller None Other Briefly describe the project plants used, irrigation changes, etc. ("After" photos must be included with this part of application.) How did you complete your project? NOTES: Self Contractor Other The following information will help us evaluate program water savings: (your information will NOT be sold or distributed) 1) How many people reside in your home? 2) Do you have a pool and/or fountain? Pool: Yes No Fountain: Yes No 3) Do you have a vegetable garden? Yes No 4) Are there any additional high water use needs in the home, such as healthcare?

RESIDENTIAL TURF REMOVAL PROGRAM APPLICATON Part 2 Rebate Request CUSTOMERS OF GOLDEN STATE WATER CO. in the Cities of: CLAREMONT, SAN DIMAS, LA VERNE, CHARTER OAK, and portions of MONTCLAIR, POMONA AND UPLAND REBATE amount is up to $2.00 per square foot of turf removed Total amount to be rebated will not exceed $6,000 per residence. Additional Requirements for the Turf Removal Rebate DO NOT start your project prior to submitting your application and receiving the mandatory preinspection and notice to proceed! In addition to the requirements on the front page of the application, the following requirements are also in place for the areas listed above. Areas visible from the street are the preferred areas of retrofit for this program. Front yards and side setback areas should be implemented first. Backyard turf removals will be eligible only if the existing front yard landscaped areas have no more than 30% turf. Converted area cannot be covered with impermeable surfaces such as concrete, brick, pavers or asphalt. Decomposed granite, gravel, mulch, and live plants are acceptable turf replacements. Use of permeable weed barrier fabric is highly encouraged. Before pictures shall be taken no more than 6 months prior to project start date verification of existing conditions may be done by water agency staff prior to approval of rebate reservation. Before and After pictures must cover the entire retrofitted area. Provide a drawing of your new landscape plans. Rough sketch is allowable. Full plant list must be provided with application. (A full list of acceptable plants can found at www.bewaterwise.com). Applications may be denied based on the plant palette chosen. Golden State Water Co. (Claremont and San Dimas) Turf Removal Rebate Program 06/2014

At least 50 percent of the front and street side setback areas are required to be covered and maintained with some combination of live trees, shrubs, vines, ground covers, flowers, existing or other types of drought tolerant vegetation. The calculation of 50 percent may include the area between plants that are spaced in consideration of their mature size, and any area under an existing drip line of a tree that is covered and maintained with a permeable material such as mulch or decomposed granite. Bare soil must be covered by mulch, decomposed granite, or rock to prevent soil erosion. Edible landscapes will be considered for the rebate, but must be outfitted with drip irrigation and year round plantings must be included as a part of the plan s plant list. Raised bed construction is highly recommended as a part of an edible landscape plan, but not required. All projects must meet your city s requirements for landscape ordinances and codes as applicable. Water agencies are not responsible for projects that do not meet your city s requirements An approved plan from your local city planning department is highly recommended as a part of your application, especially in cases where the turf removal will exceed 1,000 square feet. Check with your local city planning department if your retrofit is larger than 5,000 square feet. It may be subject to additional Water Efficient Landscape requirements. Residents in homeowners associations will be responsible to check with the association s Board for the landscape requirements in their specific areas. Water agencies and local cities have no jurisdiction within homeowners associations for landscape requirements. If you have any specific questions about your city s landscape requirements, please call: City Phone # Claremont (909) 399 5470 La Verne (909) 596 8741 San Dimas (909) 394 6200 Golden State Water Co. (Claremont and San Dimas) Turf Removal Rebate Program 06/2014