Appendix C Sample Certificate of Completion

PART 1. PROJECT INFORMATION SHEET

 

Date
Project Name
Name of Project Applicant	Telephone No.
	Fax No.
Title	Email Address
Company	Street Address
City	State	Zip Code

 

Project Address and Location:

 

Street Address		Parcel, tract or lot number, if available.
City		Latitude/Longitude (optional)
State	Zip Code

 

Property Owner or his/her designee:

 

Name	Telephone No.
	Fax No.
Title	Email Address
Company	Street Address
City	State	Zip Code

 

Property Owner

“I/we certify that I/we have received copies of all the documents within the Landscape Documentation Package and the Certificate of Completion and that it is our responsibility to see that the project is maintained in accordance with the Landscape and Irrigation Maintenance Schedule.”

___________________________________________________________________________________________
Property Owner Signature                  Date

Please answer the questions below:

1. Date the Landscape Documentation Package was submitted to the local agency          

2. Date the Landscape Documentation Package was approved by the local agency          

3. Date that a copy of the Water Efficient Landscape Worksheet

   (including the Water Budget Calculation) was submitted to the local water purveyor      

PART 2. CERTIFICATION OF INSTALLATION ACCORDING TO THE LANDSCAPE DOCUMENTATION PACKAGE

   “I/we certify that based upon periodic site observations, the work has been completed in accordance with the ordinance and that the landscape planting and irrigation installation conform with the criteria and specifications of the approved Landscape Documentation Package.”

 

Signature*	Date
Name (print)	Telephone No.
	Fax No.
Title	Email Address
License No. or Certification No.
Company	Street Address
City	State	Zip Code

 

   *Signer of the landscape design plan, signer of the irrigation plan, or a licensed landscape contractor.

PART 3. IRRIGATION SCHEDULING

Attach parameters for setting the irrigation schedule on controller.

PART 4. SCHEDULE OF LANDSCAPE AND IRRIGATION MAINTENANCE

Attach schedule of Landscape and Irrigation Maintenance.

PART 5. LANDSCAPE IRRIGATION AUDIT REPORT

Attach Landscape Irrigation Audit Report.

PART 6. SOIL MANAGEMENT REPORT

Attach soil analysis report, if not previously submitted with the Landscape Documentation Package.

Attach documentation verifying implementation of recommendations from soil analysis report.

(Ord. 814-2015, 2016)