WATER EFFICIENT LANDSCAPING
STATEMENT OF CONFORMANCE AND
CERTIFICATE OF COMPLETION
Effective January 1, 2010, development projects that require a building permit, plan check,
design review or other discretionary permit shall comply with the State of California’s Model
Water Efficient Landscape Ordinance. This form shall be used for projects that are not served
by the Marin Municipal Water District or North Marin Water District. A certified or licensed
landscape design professional must confirm below whether the landscape plan complies with
the water efficiency in landscaping design requirements of the State of California’s Model Water
Efficient Landscape Ordinance, which is available at:
http://www.water.ca.gov/wateruseefficiency/docs/MWELO_TbContent_Law.pdf
Landscape design professionals include, but are not limited to, landscape architects, landscape
contractors, irrigation designers, or golf course architects.
Project Name/Applicant:
________________________________________________
Project Address:
________________________________________________
Landscape Plan Reference:
________________________________________________
Landscape Design Professional:
________________________________________________
Address/Telephone Number:
________________________________________________
STATEMENT OF CONFORMANCE (To be wet-stamped and signed prior to issuance of a
building permit)
I hereby state that the landscape plan submitted for the project identified above conforms to the
State of California’s Model Water Efficient Landscape Ordinance and a Landscape
Documentation Package has been filed with the Marin County Community Development
Agency.
Date:_______________
________________________________________________
State license stamp with signature
CERTIFICATE OF COMPLETION (To be wet-stamped and signed prior to project occupancy)
I hereby state that the landscape plan approved for the project identified above was installed in
conformance with the Landscape Documentation Package that is on file with the Community
Development Agency and conforms to the State of California’s Model Water Efficient Landscape
Ordinance.
Date:_______________
________________________________________________
State license stamp with signature