Non-Medical Cannabis Retail Stores Application Form

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Development Services City of West Kelowna 2760 Cameron Road West Kelowna, BC V1Z 2T6 Phone: 778-797-8830 Fax: 778-797-1001 Non-Medical Cannabis Retail Stores Application Form An application for a non-medical cannabis retail license shall be submitted to the Liquor and Cannabis Regulation Branch (LCRB) prior to submitting an application to the City. All proponents seeking a new nonmedical cannabis retail licence shall apply to the City for site-specific rezoning to permit this use in accordance with the Non-Medical Cannabis Retail Store Rezoning Policy and City of West Kelowna s Development Applications Procedures Bylaw. The City will make every effort to review the rezoning applications for a non-medical cannabis retail store concurrently with the Provincial review, where possible. Initial rezoning applications for non-medical cannabis retail stores will be accepted by the City for an initial intake period from: 8:30 a.m. on October 17, 2018 to 4:00 p.m. on January 2, 2019. Please note that the City of West Kelowna offices will be closed December 25 th, 2018 to January 1, 2019 for the holiday season. Applicants must review the Non-Medical Cannabis Retail Store Rezoning Policy prior to submitting an application. Following the closure of the intake period, the City will review the applications and any incomplete applications will be closed and application documents will be returned to the applicant. The time period associated with the review of the applications from the initial intake period will be dependent upon how many applications the City receives. However, the City will strive to review the applications on a timely basis. The City will post its anticipated timeframe for review on the City s website following the closure of the intake period once the total number of submitted applications is known. Applicant Information Applicant/Agent Name(s) (or Company Name/Contact Person): Registered Owner(s) of the Property Name(s) (as they appear on Title): Mailing Address: Mailing Address: City, Province, Postal Code: City, Province, Postal Code: Phone (Daytime) / Phone (Other): Phone (Daytime) / Phone (Other): Email: Email (and contact name if company): City of West Kelowna Non-Medical Cannabis Retail Store Application Form 1

Agent Authorization Form If the applicant is not the registered owner, please attach a Letter of Authorization from all registered property owners or have all registered owners sign the Agent Authorization Form below. As owner(s) of the land described in this application, I/we authorize to act as my/our Agent in regard to this development application. I/we further declare that my/our Agent is hereby authorized to make necessary changes to this application and associated documents and plans. Name: Signature: Name: Signature: Date: Date: NOTE: For properties with more than two registered owners, please attach a separate Letter of Authorization. Property Information Legal Description(s): Civic Address(es): Official Community Plan Designation(s): Current: Proposed: Zoning: Current: Proposed: Neighbourhood Location: Current Land Use (brief description): Proposed Land Use or Proposed Variance (brief description): Have you reviewed the Non-Medical Cannabis Retail Store Rezoning Policy, the City of West Kelowna Procedures Bylaw and the City of West Kelowna Fees and Charges Bylaw? Yes Current Method of Sewage Disposal: Community Sewer Septic Tank Other Current Method of Water Supply: Community Water Well Other Development Application Attachments (To be confirmed by Staff). Type of Application Existing Building New Building Minimum Application Attachments A,B,C,D,E,F,G,H,I,J,K,L,M,N,O,P,Q,R A,B,C,D,E,F,G,H,I,J,K,L,M,N,O,P,Q,R,S,T,U City of West Kelowna Non-Medical Cannabis Retail Store Application Form 2

Attachment Details Staff to check the box on the left if attachment is required. Attachment Details A Land Title Certificate A copy of the title(s), issued not more than 30 days prior to the application date, for any parcel of land subject to the application. B Title Documents (restrictive covenants, easements and rights-of-way, etc.) Copies of all non-financial charges (i.e. restrictive covenants, easements and rights-of-way, etc.) registered on the subject property(s). A copy of the title(s) and related documents can be obtained directly from the Land Title Office or through a Government Agent s Office, a notary, lawyer or title service company. C Agent Authorization Written consent of all property owners appointing an agent for all purposes associated with the application. Refer to the Agent Authorization Form on page 1 of this application. D E F Rezoning Application Fee $7500.00 Site Profile for Contaminated Sites (OR Site Profile Waiver) Copy of the Liquor and Cannabis Regulation Branch Application An application fee shall accompany the application as per the CWK Fees and Charges Bylaw. The CWK Fees and Charges Bylaw outlines the refund eligibility for applications. An Official Community Plan amendment may also be required as part of the Non-Medical cannabis retail store rezoning application. The OCP amendment fee is an additional $900.00. In accordance with the Waste Management Act, applicants are required to submit a Site Profile Form for development (see attached Schedule A) on properties that are or were used for commercial and industrial activities and other uses as defined in provincial regulations (i.e. listed Schedule 2 activities). Properties that are exempted from this legislation are required to submit a CWK Site Profile Waiver Form attached to this document as Schedule B. Application forms are available at the Liquor and Cannabis Regulations Branch website: https://www2.gov.bc.ca/ (LCRB Retail Store Application). G Proposal Summary An outline of proposed development or land use including: An explanation of the community and/or neighbourhood benefit; An explanation of and rationale for the impacts of the proposal, including any impacts to surrounding uses and any biophysical constraints; and An explanation of how the development meets the Commercial Development Permit Guidelines of the OCP and Westbank Centre Design Guidelines where applicable. H Description of How Nuisance Behavior Will be Mitigated Detailed description of how potential nuisance behavior, such as consumption of product outside the store premises, odors from ventilation, etc., is to be managed and mitigated (i.e. location of venting, carbon filters, etc.) to reduce any nuisance activity on established businesses and residents in the surrounding area which may result from the operation of a non-medical cannabis retail store. I Data Summary Sheet An outline of parcel area (m 2 ), parcel coverage (%), parcel frontage (m), front setback (m), interior side setback (m), exterior side setback (m), rear setback (m), setbacks from A1 zone (m), building height (m), gross floor area (m 2 ), density, number of proposed units and off-street parking and loading spaces, private amenity space (m 2 per unit), and other relevant data based on the application type. J K Notice of Application Sign Site Plan(s) (level of detail to be checked off by Development Services; all plans to include: legend, title, date, north arrow, and scale) A Notice of Application Sign will be required for applications that advance to consideration of First Reading. These applicants will be notified by staff when an application sign is required. Site plan(s) of the proposed development drawn to scale and showing all dimensions in metric. The site plan(s) may require the following: The civic address and full legal description of the property; All existing or required covenants and easements; the names and extent of roads and lanes adjacent to the property; Location of any existing community services of sanitary sewer, water, storm drainage and rights-of-way on the site or adjacent to the property; Location of existing wells or other water sources on the property; Location of existing/proposed septic fields; Location and dimensions (including setbacks) of existing and proposed buildings and structures on the site (a recent survey plan is preferable); Location of any watercourses, steep banks or slopes on or adjacent to the property; Location of retaining walls, ditches, fire hydrants, fire department connections, gas lines, kiosks, hydro and telecommunications poles; and Location and dimensions of existing or proposed access(es) to the property, driveways, manoeuvring aisles, parking layout, and amenity areas. City of West Kelowna Non-Medical Cannabis Retail Store Application Form 3

L Floor Plans A floor plan of the proposed store drawn to scale and showing all dimensions in metric. The floor plan must indicate how the layout will mitigate the entrance of minors. M Development Plans Detailed drawings of the proposed development, including building sections, elevation drawings, coloured renderings including a description of how the exterior building design complies with the OCP Commercial Development Permit Guidelines and Westbank Centre Design Guidelines as applicable. N O P Minimum Separation Distance Map(s) Municipal Bylaw Compliance History Crime Prevention Through Environmental Design Analysis All proposals shall indicate how the proposed exterior of the building enhances the street character. Provide separation distance mapping from all sensitive uses based on the Non-Medical Cannabis Retail Store Policy (for the applicable neighbourhood area), including: Location of the proposed non-medical cannabis retail store location; Identification of the sensitive use(s); and Separation distance based on the measurement methodology outlined in the Policy. Include a list of all proponents (applicants, directors, business owners, etc.) associated with the non-medical cannabis retail store and clearly demonstrate that they do not have a history of infractions related to the business operation within the City. Include an analysis by a professional competent in Crime Prevention through Environmental Design (CPTED) and demonstrate how the proposed building can meet the Provincial Physical Security Requirements. Q Operational Plan Operational Plan should demonstrate the details of the operation of the proposed business, including proposed hours of operation, experience of applicants/owners, and the proposed plan for ensuring the business is in compliance with Federal, Provincial and municipal regulatory frameworks. R Landscape Plans (separated inset planting plans are acceptable) Landscape plan drawn to scale and showing dimensions. The submission must include: Existing and/or proposed screening, landscaping and fencing; Detailed planting plan showing species density and locations with the entire site on one plan; Cost estimate prepared by a Landscape Architect for the proposed works including: plantings, irrigation, labour, inspections, monitoring, and maintenance; Security in the amount of 125% of the estimated costs of the works. S T U Stormwater Management Plan and/or Drainage Plan Functional Servicing Report (FSR) The applicant may be required to provide additional reports and impact studies, including but not limited to the following: For large developments on sites with complex drainage patterns, a drainage plan may be required for the entire site and the downstream basin or basins that may be affected. In such cases, a Terms of Reference will be prepared by CWK. An FSR is intended to ensure the adequacy of the existing and proposed water and sanitary sewer systems to satisfy the demands of the proposed development. An FSR is required for any application that proposes a change in land use or occupancy. Planning Environmental Report or Impact Assessment Geotechnical Study Other Studies as Deemed Necessary Development Engineering Transportation and Traffic Impact Study Site Access and Servicing Composite Utility Plan (including Rights of Way) Transportation and Circulation Analysis NOTE: The personal information on this form is collected under the authority of the Local Government Act and/or Community Charter for the purposes of processing this application, and is subject to the Freedom of Information and Protection of Privacy Act. Any questions regarding the collection of information should be directed to the Legislative Services Department, phone: 778-797-2250. City of West Kelowna Non-Medical Cannabis Retail Store Application Form 4