• Please read instructions completely before submitting the online application.
  • All fields/sections must be filled in and supporting documents are attached to avoid delays in processing your request.
  • Customer Name, Customer and Account Numbers must match what is shown on your Water Bill.
Account Information
Customer #
(7 numbers only)
Account #
(8 numbers only)
*If your account # begins with 29 or 80, apply through www.socalwatersmart.com
*If your account # begins with 36, apply through lawnreplacement.clwa.org
(Click to Validate Customer # and Account # to Unlock the Form)
Customer Name
(Last Name or Business Name) (First) (MI)
Service Address

(House #, Street Name) (City) (Zip)
Billing Address
(if different)

(House #, Street Name) (City and State) (Zip)
Daytime Phone #
How did you hear
about the program?
(select one)
E-Mail
Repeat E-Mail
Confirmation email will be sent upon successful application submittal.
Site Information
Total Sq. Ft. of grass to be removed (A minimum of 500 square feet up to a maximum of 5,000 square feet of grass should be converted)
  (Select all the area(s) of conversion)
Type of irrigation to be installed
Sq. Ft. of plant coverage
Expected date of completion
(Type Date as "mm/dd/yyyy" )
Upload Supporting Documents
Supporting documents must be in PDF, JPG or DOC(X) format. Max file size: 5 MB each. Select up to 10 documents.
Documents attached to this application will be considered public records. All personal identifiable information (date of birth, social security number etc.) should be redacted from the documents that are attached to this application.
Additional documents can be emailed to rebates@pw.lacounty.gov
Attaching inappropriate or harmful photos or documents will result in rejection of rebate application.


Signature

I have read, understand, and agree to the terms and conditions of the program. I certify that the information on the application is true and correct.

- Customer Initials(must match First and Last Name)
Customer/Owner Name (Type First and Last Name)
Date
(Type Date as "mm/dd/yyyy" )

If someone assisted Customer to complete this form please provide the contact information below:
Assistant Name:
Phone:
Email:
Repeat Email: