Water Energy Community Action Network Landscape Efficiency Upgrade Rebate Residential Registration Form

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1 Water Energy Community Action Network Landscape Efficiency Upgrade Rebate Residential Registration Form Name: Phone: Mailing Address: Check here if you do not have an address or if you would prefer to stay in communication through US Mail. This does slow our rebate process down. Street Unit City State Zip Code Street Address (if different than your mailing address): Street Unit City State Zip Code I receive a water bill from: City of Fresno City of Clovis City of Reedley (Circle one) Other: If you are on domestic well, please indicate if your well is metered: Yes No Please indicate if you are participating or planning to participate in another landscaping rebate program: City of Fresno Lawn to Garden Conversion Micro Irrigation Conversion Rain Sensor Smart Irrigation Controller Soil Moisture Sensor Sprinkler Nozzles State of California Save Our Water Rebate Turf Replacement

2 WE CAN Rebate Information The WE CAN rebate program, funded by the Department of Water Resources Water- Energy Grant Program, is designed to reduce outdoor water consumption, and in doing so, reduce energy use and greenhouse gas emissions. Our rebate program requires just a few easy steps: 1. Submit your Pre-Project Application to the Local Government Commission to wecaninfo@lgc.org with the subject line Rebate Pre-Project Application First Name Last Name, or by mail to: Local Government Commission WE-CAN Rebate Program th Street Sacramento, CA Receive project approval from LGC staff prior to starting your project. 3. Complete approved project within 3 months. 4. Submit the Completion Packet. Eligibility for the WE CAN rebate program is based on census tracts within Fresno County region. We will confirm your eligibility by your physical address. Applicants must also be metered whether on a municipal supply or a domestic well. Rebate Timeline A rebate check will be delivered to a successful applicant approximately 4-½ months* following Pre-Project Approval. Rebate turn-around time is dependent on when the project is completed within the 3-month time allowance and the date of your Completion Package. *We will request the rebate funds from DWR on the 1 st of the month following the date of your completion package, not on the date of submission. We will receive these funds within 1 month of placing the request, and will mail checks to successful applicants within two weeks of receiving them from DWR. Rebate Requirements & Eligible Materials Reader Agreement In order to participate in the WE-CAN Rebate Program, we respectfully request permission for access to your water utility account information. This information will be used by LGC to quantify the water and energy savings realized as a result of the Rebate Program. Any publication of your water usage information will be anonymous and devoid of personal or identifying information. Please sign the attached Release of Information Form for your water utility in order to participate in the Rebate Program. Turf Conversion We offer $1/sq. ft. up to $1,000 for our Turf Conversion rebate. This rebate should be coupled with the State's Save Our Water Turf Conversion Rebate and your local city program (if applicable), to reach the full $2/ sq. ft. The City of Fresno offers several different rebate options, including a Lawn to Garden Conversion rebate.

3 Converted area is limited to Central-Valley specific California native plants, or non-native plants adapted to USDA Climate Zone 9. Rebate requires a minimum of 250 sq. ft. conversion to water efficient landscaping. At maturity, plants must cover 50% of the converted area. Any design elements that are not plant material, such as planters, rocks, mulch, or similar elements must be integrated and cohesive part of the overall landscape design. may be installed but must be made from a permeable material such as pavers, permeable concrete, or crushed stone. Rebate will not cover the installation of non-permeable surfaces and non-permeable areas do not count towards final square footage. Eligible Products and Materials Drought Tolerant vegetation o Central Valley Specific CA Native Plants o Non-native plants adapted to USDA Climate Zone 9 o UC Verde Buffalo Grass* o Please see WUCOLS plant guide for help selecting qualifying plants Permeable Landscapes o Decomposed granite o Gravel, rock, stone, o Crushed stone o Interlocking pavers o Flagstone Pavers o Permeable Concrete o Open grid pavers *Please not that no more than 20% of the converted landscape can be turf. Irrigation Efficiency Upgrade & Graywater Installation For our Irrigation Efficiency & Graywater Systems rebate, we offer $1/sq. ft. up to $1,000. Please note that the State Save Our Water program does not cover irrigation efficiency in their rebate program, only turf conversion. We encourage you to apply for your local city irrigation rebate if applicable. The City of Fresno offers a couple of irrigation rebates, among others. The State Save Our Water program does not cover irrigation efficiency in their rebate program, only turf conversion. Qualifying irrigation upgrades include conversion of sprinkler nozzles and heads to high efficiency sprinkler nozzles, conversion to drip/micro irrigation, installation of pressure regulating heads, installation of landscape/irrigation only sub-meter, and/or installing soil moisture sensors. The irrigation upgrade must include installation of a WaterSense Labeled Smart Irrigation Controller. As part of our partnership with Rachio and Valley Soil, we can set up an installation of your Smart Controller using money from your irrigation efficiency upgrade (~$500). This includes the smart controller as well as a site assessment, installation of the smart controller, and training on how to set it up and use it.

4 If you are installing a graywater system, the rebate covers both materials and installation costs for code-compliant graywater systems. The graywater system starts at the drain. The rebate will pay for labor and equipment including pipe, tanks, pumps, fittings, valves, filters, irrigation system parts, installation costs, basin materials (e.g. mulch, wood chips), plants and other related items. The City of Fresno requires a permit to install a graywater system. Please visit the Irrigation Efficiency & Graywater Systems Rebate page on the website to learn about the permit requirements. Pre-Project Application Checklist Pre-Project Application Rebate Program Affidavit Water Data Release Form 3-5 Before photos Photo/Video Release (optional) Please scan and this application to wecaninfo@lgc.org with the subject line Rebate Pre-Project Application First Name Last Name, Or, mail it to: Local Government Commission WE-CAN Rebate Program th Street Sacramento, CA For any questions, please call (916) x302 or wecaninfo@lgc.org. Project Plan Please indicate below your proposed landscape upgrade plan. Please make sure to complete your landscape plan and description for your Turf Conversion and/or Irrigation Efficiency and Graywater Systems rebate. Rebate Options (you may select more than one): Turf Conversion Irrigation Efficiency Upgrade Graywater Installation Turf Conversion Rebate: Project Plan Please fill out the following fields if you intend to do a Turf Conversion landscape upgrade. If you only plan to apply for our Irrigation Efficiency & Graywater Systems upgrade, please continue to the section. If you are applying to both programs, you can fill out your irrigation efficiency and/or graywater system plan details with your turf conversion plan in the fields below or fill out each rebate project plans separately. Square footage you plan on converting:

5 Turf Conversion Rebate: Description Please write a short description (a bulleted list would be sufficient) of the plants and other landscaping materials you plan on using for the turf replacement rebate: Example: 750 sq feet of Turf replaced with decomposed granite and the following native plants: o lavender o deer fern o catsclaw vine and climbing blueberry along the house o a chase tree o two acacia trees o moss verbena ground cover. I am also replacing my existing spray irrigation with high efficiency in-line drip tubing and installing a Rachio Smart Irrigation Controller.!!! Turf Conversion Rebate: Before Pictures Please take 3-5 photographs of your current landscaping. At least one of these before pictures must include an identifying feature, such as your home address. For reference, please take a look at the California State photo guidelines: In the space below, sketch out your landscape area and upgrade plan. This can be as simple or detailed as you see fit as long as it includes: 1. Measurements of your planned retrofit area (in feet or inches) along all borders. 2. Placements for all of your plants 3. A legend showing what symbols were used for each plant type.

6 Turf Conversion Rebate: Landscape Plan Landscape)Plan:) Legend:)

7 Irrigation Efficiency & Graywater Systems Rebate: Project Plan Please fill out the following fields if you intend to apply for the Irrigation Efficiency & Graywater Systems rebate. Square footage you plan on converting for the irrigation efficiency & graywater systems rebate: Please check if you will be participating in our Smart Controller Program (free site assessment, smart controller, installation, and training). The total cost of this ( ~$500 of the irrigation portion of your rebate will be used for the controller. Irrigation Efficiency & Graywater Systems Rebate: Description Please write a short description (a bulleted list would be sufficient) of the irrigation and/or graywater system materials you plan on using: Example: I am replacing my existing spray irrigation with high efficiency in-line drip tubing and installing a Rachio Smart Irrigation Controller.!!! Irrigation Efficiency & Graywater Systems Rebate: Before Pictures Please take 3-5 photographs of your current landscaping. At least one of these before pictures must include an identifying feature, such as your home address. For reference, please take a look at the California State photo guidelines: In the space below, sketch out your landscape area and upgrade plan. This can be as simple or detailed as you see fit as long as it includes: 1. Measurements of your planned retrofit area (in feet or inches) along all borders. 2. Placements for all of your plants

8 3. A legend showing what symbols were used for each plant type. Irrigation Efficiency & Graywater Systems Rebate: Landscape Plan Landscape)Plan:) Legend:)

9 Water Energy Community Action Network Landscape Efficiency Upgrade Rebate Residential Registration Form Agreement I, the Undersigned, have requested to participate in the Local Government Commission s WE CAN Landscape Rebate Program. As a condition of participation in the Program, I understand and agree to the following under penalty of perjury: I understand... I may receive an amount not to exceed $1000 for participating in the Turf Conversion Rebate and an amount not to exceed $2000 for participating in the Irrigation Efficiency & Graywater Systems Rebate I assert that I am legally permitted to complete work on my property. If I am a renter, I am eligible to participate if I have received the written consent of the property owner. Renters, please initial to assert that you have received written consent to participate from your landlord. Initial: I understand that this is a limited, first-come, first-serve program and may be terminated at any time. I understand that rebates will only be given to Participants who have received project approval prior to commencing the work set forth in the application. I understand that the Local Government Commission is entitled to deny any application that does not meet program requirements. I grant the Local Government Commission and approved contractors permission to access my water usage data through my utility for the purpose of collecting data (see addendum); identifying data will not be used for commercial, media, or other purposes. I am responsible for complying with all applicable laws, regulations, ordinances, or other legal requirements and nothing in this Agreement shall excuse or modify any such requirement. I understand that I am responsible for completing my project within 3 months of receiving approval from Local Government Commission staff. I may complete my project myself or hire a contractor to do the work. In either case, the Local Government Commission and its contractors are not liable for any damage to my lawn or property in any way connected to the project. I understand that if my project will take longer than 3 months since the date of receiving approval, I must submit an extension via mail or at my earliest convenience and before expiration of the 3-month time frame. Upon completion of my retrofit project, I will submit my completion package. My completion package will include itemized receipts and invoices associated with the project, plus photographs of the components listed on the receipts and invoices, including at least 3 photographs of the completed project with an identifying feature, such as a street address. If I do not submit my completion package by the end of the 3 month timeframe or approved extension period, I will be found ineligible and will not receive a WE CAN rebate.

10 I agree that I am subject to a post-completion verification where Local Government Commission, it s staff, contractors, or associates may enter my property, take photographs, check/evaluate my irrigation and/or graywater system, check and evaluate plant selection, and verify upgrade installation. By virtue of these inspections, I understand that Local Government Commission makes no determination with respect to whether materials and equipment are free of defects, the quality of the workmanship, or the suitability of the premises or the materials or equipment for the installation. If this Application is approved by Local Government Commission and the work proceeds, I agree to defend, indemnify and hold harmless Local Government Commission, its directors, officers, agents, contractors, and employees against any and all loss, liability, expense, claims, suits and damages, including attorneys fees, arising out of or resulting from the installation of irrigation equipment and landscape materials. Turf Conversion Rebate (High-visibility areas will be given priority) I understand that each converted area must include central-valley specific California native plants, or non-native plants adapted to USDA Climate Zone 9. Please see the California Department of Water Resource s WUCOLS (Water Use Classification of Landscape Species) database (available with photographs through for a listing of plants classified as low or very low water use in California. I understand that at maturity, plants must cover 50% of the converted area. Any design elements that are not plant material, such as planters, rocks, mulch, or similar elements must be integrated as a part of the converted area s landscape design. Pathways may be installed and may count towards the total square footage converted but they must be made from a permeable material such as pavers, permeable concrete, and crushed stone. Installation of impervious surfaces or artificial turf does not count towards the conversion rebate. I understand that if I irrigate my landscape with an automated irrigation system, it must be high efficiency irrigation as outlined in the irrigation rebate, and must have an EPA WaterSense Labeled Smart Irrigation Controller installed and functioning. Irrigation Upgrade Rebate: I understand that the irrigation upgrade includes conversion of sprinkler nozzles and heads to high efficiency sprinkler nozzles, converting to drip/micro irrigation, installation of pressure regulating heads, installation of a landscape/irrigation-only sub-meter, and/or installation of soil moisture sensors. The irrigation upgrade must include installation of a WaterSense Labeled Smart Irrigation Controller. Greywater Rebate Local Government Commission will rebate qualifying greywater irrigation system costs at $2/sq. ft up to $2,000 per household. The rebate covers both materials and installation costs for codecompliant greywater systems. The greywater system starts at the drain. The rebate will pay for pipe, tanks, pumps, fittings, valves, filters, irrigation system parts, installation costs, basin materials (e.g. mulch, wood chips) and other related items.

11 Please note the following are not eligible for rebate: Upgrades and conversions that result in overspray, run-off or uneven coverage; Irrigation zones with mismatched sprinkler types of heads in the same zone Turf, artificial turf, or no mow grass I have read, understand, and agree to the terms and conditions of this rebate program. Print Signature Date

12 Local Government Commission Standard Media Release Form Date I, the undersigned, hereby authorize the Local Government Commission to photograph, take video footage, and/or make electronic sound recordings of me (herein referred to as photographic or electronic reproductions). I authorize the use of any such photographic or electronic reproductions of me for any purpose, including, but not limited to educational and other public media as may be deemed appropriate by the Local Government Commission (I understand that I may be identifiable from such photographic or electronic reproduction) Agreed and accepted by: Print Name Title Address City, State, Zip Phone Signature Date

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