1. The applicant’s full name (including any current or prior aliases, or other legal names the applicant is or has been known by, including maiden names), current address, and telephone number.

2. The address where notice of action on the application is to be mailed.

3. The applicant’s previous addresses for the two (2) years immediately prior to his or her present address.

4. Written proof that the applicant is over the age of 21 years of age.

5. The applicant’s height, weight, color of eyes and hair.

6. Two (2) passport-quality, current photographs of the applicant.

7. A birth certificate, passport, or valid California Driver’s License (not to include an AB60, federally restricted license).

8. The applicant’s business license and a copy of the applicant’s seller’s permit (retail sales tax permit) issued by the State Board of Equalization.

9. All the name or names and addresses of the person or persons who will act as a manager or supervisor of the dispensary or delivery only dispensary.

10. Pursuant to California Penal Code Sections 11105(b)(11) and 13300(b)(11), which authorizes city authorities to access state and local summary criminal history information for employment, licensing, or certification purposes; and authorizes access to federal level criminal history information by transmitting fingerprint images and related information to the Department of Justice to be transmitted to the Federal Bureau of Investigation, every person listed as an owner, manager, or supervisor of the marijuana business must submit fingerprints and other information deemed necessary by the City Manager or his/her designee(s) for a background check by the Clearlake Police Department. Pursuant to California Penal Code Sections 11105(b)(11) and 13300(b)(11), which requires that there be a requirement or exclusion from employment, licensing, or certification based on specific criminal conduct on the part of the subject of the record, no person shall be issued a permit to operate a marijuana business or a related work permit unless they have first cleared the background check, as determined by the Chief of Police, as required by this section. A fee for the cost of the background investigation, which shall be the actual cost to the City to conduct the background investigation as it deems necessary and appropriate, shall be paid at the time the application for a marijuana business permit is submitted. If this amount is not sufficient, the applicant shall provide additional amounts that are necessary and if the applicant is unable to provide the additional amounts necessary to complete the investigation, the investigation shall cease and shall not continue until such additional amounts are paid. Upon completion of the investigation or in the event the applicant withdraws their application, any fees paid for this process will be deemed non-refundable.

11. A written statement listing the physical size of the dispensary or delivery only dispensary, the number of managers, supervisors, employees and volunteers who will work there, and describing the nature of the proposed use of the dispensary or delivery only dispensary.

12. A security plan describing security arrangements that will ensure the safety of persons visiting and working at the dispensary or delivery only dispensary, and protect the premises from theft. The plan shall provide for: installation of security cameras; installation of a burglar alarm system monitored by a State-licensed monitoring service; and a periodic (no less than yearly) written security assessment of the site conducted by a qualified professional.

13. A sketch or diagram depicting the interior configuration of the premises, including the total floor area occupied by the dispensary or delivery only dispensary. The sketch or diagram must be drawn to a designated scale or drawn with marked dimensions of the interior of the premises to an accuracy of plus or minus six (6") inches.

14. A sketch or diagram showing exterior configuration of the premises, including the outline of all structures, parking and landscape areas, and property boundaries. The sketch or diagram must be drawn to a designated scale or drawn with marked dimensions to an accuracy of plus or minus six (6") inches.

15. A straight-line drawing accurately depicting the building (or portion thereof) and premises to be occupied by the dispensary, and all properties within six hundred (600') feet of the boundaries of the property on which the dispensary or delivery only dispensary license is requested. The drawing shall indicate the property lines of any youth-oriented facility and all residential zones or uses within one hundred (100') feet of the primary entrance of the dispensary.

16. A lighting plan showing existing and proposed exterior and interior lighting placement and levels to provide adequate security lighting and which comply with all City standards regarding lighting design and installation.

17. Written authorization for the City, its agents and employees to seek verification of the information contained in the application and/or required pursuant to this Chapter.

18. A notarized statement by the property owner certifying under penalty of perjury that he or she has given consent to the applicant to operate a dispensary or delivery only dispensary at the location, or providing proof that the applicant owns the property.

19. A written statement by the applicant certifying under penalty of perjury that all the information contained in the application is true and correct.

1. The licensee shall provide a detailed description of any changes proposed or that have occurred in dispensary or delivery only dispensary operations, the reasons for such changes, including compliance with applicable local and State law.

2. The licensee shall identify any problems encountered during operations and how they have been addressed.

3. If the licensee operates or has operated a cooperative or collective under Health and Safety Code section 11362.775 within the City, the licensee shall describe how the cooperative or collective operations complied with the requirements of this section and with applicable local and State law.

1. The make, model, year, photograph and registration information for all vehicles used to make deliveries. Photographs must illustrate that a vehicle used for deliveries is equipped with a secure lockbox, as described in Section 5-20.2c.1.

2. Standard operating procedures to ensure that marijuana is delivered in accordance with state law, including, but not limited to, procedures for verifying the identity of the person submitting and receiving a delivery both before an order is taken and at the time of the delivery.

3. Standard operating procedures to ensure the licensee maintains a delivery log of the following documents and information relating to each delivery:

4. A valid California Driver’s License for all delivery personnel. (Ord. #201-2017)