Part 1 — PROJECT INFORMATION SHEET — Gridley Municipal Code

Date
Project Name
Name of Proect Alicant	Telephone No.
j pp	Fax No.
Title	Email Address
Company	Street Address
City	State	ZipCode

Project Address and Location:

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

Property Owner or his/her designee:

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

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:

Date the Landscape Documentation Package was submitted to the local agency
Date the Landscape Documentation Package was approved by the local agency
Date that a copy of the Water Efficient Landscape Worksheet

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