Customer Name
Installation Address
Date of Submission
Street
City
Fort Collins Utilities Account #
Phone
State
Zip
Email
Before Photos:
 Package has 2+ correct before photos
Notes:
Design:
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Design is between 300 and 1000 sq ft
Design is over 1000 sq ft
To be installed in phases
To be rebated in phases
Total renovation size:
Landscape Plan:
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Customer information and date
North arrow included
Scale defined and used correctly
Labeled and identified pre-existing plant material, fences, walkways, etc. – identifies what will
remain and what will be renovated
Legend with list of proposed new plant material
All plant material is from the XIP plant list and any substitutions meet required criteria
Notes describing proposed renovation
Front yard has minimum 50% plant coverage
All hardscaping is permeable
Uses edging to separate turf from other areas
Follows 7 principles of xeriscape
Parkway design complies with streetscaping regulations (if applicable)
Notes:
4/19/16
Irrigation Plan:
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Customer information and date
North arrow
Scale defined and used correctly
PSI value – static pressure noted
 Has an automatic system
 System controller location is noted
 Backflow devise location is noted
 Rain sensor location is noted (existing or planned)
 Existing sprinkler heads and type are labeled
 Zones affected by renovation are identified
 Description explaining retrofit, conversion, cap-offs or other changes that will be made to
adapt system to new landscape, including the components/devices that will be used
 Pressure reducing devices are used where applicable
 No automatic watering system
 Non-automatic systems are noted and described, including the devices (e.g. watering wand)
that will be used to water
Notes:
4/19/16