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2. Smart Irrigation Controller Retrofit Program Application
4. PROGRAM RULES AND REQUIREMENTS
   • Applicant must be a Town of Firestone water utilities customer.
   • The program is not available for new construction.
   • Only single-family residential properties can apply.
   • Only one application can be submitted per property.
   • At least one year of prior water usage at the property is required to qualify.
   • Applicant must have and maintain Wi-Fi service at the property at all times. The smart irrigation controller will continuously be connected to Wi-Fi to operate the ET weather information connection. This network connection will need to be established during set installation.
   • Smart irrigation controller retrofit must be installed, and the applicant must schedule an onsite inspection of controller retrofit with the Town of Firestone within 30 days of receipt.
   • All blanks below must be completed for the application to be processed.
   • Please allow up to 4 to 6 weeks for the application to be processed and notified that this application meets all program rules and requirements.
6. APPLICANT INFORMATION
8. Town of Firestone Water Account Number: (Located on your water bill)*
9. Property Owners Name:*
11. Property Address: (Address where controller is being installed)*
12. Mailing Address: (if different from the property address)
14. City:*
15. State:*
16. Zip:*
18. Telephone Number:*
19. Email Address:*
21. PROPERTY/INSTALLATION SITE INFORMATION
23. Does the property currently have Wi-Fi?

    1. Yes
    2. No
25. Does the property currently have a programmable irrigation system?

    1. Yes
    2. No
27. If yes, is the irrigation system installed in the front and back yard?

    1. Both front and back
    2. Front only
    3. Back only
29. If no, do you have plans to install a programmable irrigation system in the front and back yard?

    1. Yes
    2. No
31. If yes, where?

    1. Both front and back
    2. Front only
    3. Back only
32. If yes, when?
34. Number of total zones in existing or planned irrigation system:
35. How many days per week is the property irrigated normally?
37. Length of time irrigated per zone each time:
38. If no programmable irrigation system is currently installed, what is the length of time the yard is irrigated each time?
40. Current programmable irrigation controller Brand:
41. Current programmable irrigation controller Model No:
43. Date of installation of current programmable irrigation controller:
45. TERMS AND CONDITIONS
47. In order to receive the Smart Irrigation Controller Retrofit, the property owner understands and agrees to the following conditions:
    1. I understand that the controller retrofit program is subject to the availability of funding and is provided on a first-come, first-served basis.
    2. I understand, and I meet all specified program rules and requirements, and I understand that the Town of Firestone can deny any application that does not meet program rules and requirements (which can change without notification).
    3. I understand I will be responsible for picking up the controller retrofit from the Town of Firestone at 9950 Park Ave., Firestone, CO 80504, once I am notified that my application has been approved.
    4. I understand the installation of the controller and material is my responsibility.
    5. I agree that all work will comply with applicable state and local laws, ordinances, and regulations.
    6. I understand and agree that the Town of Firestone will inspect my property to confirm that the controller was installed, done so properly, and is operating for its intended purpose. If the inspection, whenever performed, shows that the device is not installed or being used as represented in this application, I agree to reimburse the Town the full price of $207.48 for a four-station controller or $232.96 for an eight-station controller, whichever I received. I agree the reimbursement would be a charge placed on my water bill for the full amount of the controller I received.
    7. I understand that the property shall be available for future inspection and monitoring (up to five years) by the Town of Firestone. Town of Firestone Water Utilities Department staff, while on-site for inspections, may take photos of the project. Property addresses participating in the controller retrofit program will be available to the public. Customer names will not be made public or associated with the property address.
    8. I understand and agree that installing irrigation equipment or landscape materials may not reduce water bills.
    9. The Town of Firestone is not responsible for the cost of installing or maintaining the Wi-Fi service used to operate and maintain the smart irrigation controller.
    10. If this application is approved by the Town of Firestone, and the work proceeds, I agree to defend, indemnify, and hold harmless the Town of Firestone, its agents, and employees against any and all loss, liability, expense, claims, suits, and damages, including attorney’s fees, arising out of or resulting from the installation of irrigation equipment and landscape equipment.
    11. I have read, understand, and agree to the terms and conditions of the program for which I am applying.
49. CHECK HERE*

    1. I agree my electronic submission of this form constitutes my signature affirming the above information is true and correct.
51. Property Owner Signature*
52. Date*
    Date
56. OFFICE USE ONLY
58. Veritification by:
59. Date
61. Application:

    1. Approved

    1. Denied
63. Additional Notes
Leave This Blank:


65. 1. Receive an email copy of this form.
66. Email address

    This field is not part of the form submission.

67. Submit Submit and Print

* indicates a required field