Chelan County Department of Community Development 316 Washington Street, Suite 301, Wenatchee, WA Telephone: (509) Fax: (509)

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Chelan County Department of Community Development 316 Washington Street, Suite 301, Wenatchee, WA 98801 Telephone: (509) 667-6225 Fax: (509)667-6475 Certificate of exemption A certificate of exemption is an optional process that is a memorialization that a particular lot has been recognized by the subdivision administrator for Chelan County as a lot of record that is not in a condition of noncompliance with the Chlean County subdivision resolution. Although the issuance of a certificate of exemption is not a guarantee that the parcel is a buildable lot, it does, however, represent an assurance to the public that Chelan County considers the lot to be a legal lot of record and that no claim to the contrary will be raised by the administrator based on the lot configuration at the time of issuance of the certificate of exemption. Contact the Planning Department to determine land use zoning and setbacks. Please provide the following information at the time of submittal. Any missing information may delay your application process. Requirements for the certificate of exemption application can be referenced in Chelan County Code 12.14.040. A completed certificate of exemption application form. Application and recording fees. A vicinity map. A narrative setting forth the reasoning as to why the exemption should be granted, including any supportive documentation (i.e. deeds, title reports, etc.). NOTE: APPLICATION FEES ARE NON-REFUNDABLE (EXCEPT RECORDING FEES). THERE ARE NO GUARANTEES THAT YOUR CERTIFICATE OF EXEMPTION WILL BE APPROVED. Upon receiving an application, a file will be setup and within 28 days after receiving the application the applicant will receive a written determination of completeness or incompleteness. After issuing the determination of completeness the Department will determine within 60 days if the proposal is approved or denied. If the application is approved the application will be sent to the Chelan County Auditor s office for official recording. This application shall be subject to all additions to and changes in the laws, regulations and ordinances applicable to the proposed development until a determination of completeness has been made pursuant to Section 14.08.030, except variance, planned development, and rezone requests. Required Prior To Recording All Taxes and Assessments for the year must be paid pursuant to RCW 84.56.345 any division, alteration, or adjustment of real property boundary lines, except as provided for in RCW 58.04.007 (1) and 84.40.042(1)(c), shall present a certificate of payment from Treasurer s. All taxes current and delinquent must be paid for. If properties are to be conveyed between two (2) separate property owners, Excise Tax Affidavit forms (check with the Chelan County Treasurer if excise tax is required or only filing fee) and Quit Claim Deeds

will need to be prepared. The department strongly recommends an attorney, or a licensed surveyor draw up the deeds for that portion of the property being transferred. A recording fee made payable to the Chelan County Auditor. ALL LAND USE APPLICATIONS AND BUILDING PERMITS REQUIRE PROOF THAT PROPERTY IS A LEGAL LOT OF RECORD. Pursuant to Chelan County Code Section14.98.1090, a legal lot of record means: (1) A lot created by a recorded subdivision or short subdivision, or (2) A lot greater twenty acres in size meeting the requirements for an exempt parcel as defined in Chelan County Subdivision Code or (3) An approved certificate of exemption, or boundary adjustment, or (4) A lot created prior to October 17, 2000 * Please note: A legal description that describes a portion of a lot or a metes and bounds description does not constitute a legal lot. *You must prove the lot existed prior to this date by providing a copy of the deed that shows the recorded date. Contact a title company or the auditor s office for assistance with this research. If none of the above applies, then you must legalize the lot through a short plat, major subdivision, certificate of exemption, or increase the lot size to greater than 20 acres. A recorded survey does not create a legal lot of record unless the lot is greater than 20 acres. CANNABIS DISCLOSURE SECTION SUB-SECTION I: Circle I AFFIRM there IS NOT or IS (circle one) an existing or pending Liquor and Cannabis Board (LCB) license or approval for cannabis production, processing, or retail located on the property that is the subject of the requested development permit or approval. If you circled IS NOT above, proceed to Sub-Section III of this form. If you circled IS above, proceed to Sub-Section II of this form. SUB-SECTION II: You must read the below statements, initial on the space provided, and then proceed to Sub-Section III. I ACKNOWLEDGE AND UNDERSTAND that all cannabis-related activities, development, uses and construction must comply with Chelan County regulations, including but not limited to Chelan County Code Section 11.100. I ACKNOWLEDGE AND UNDERSTAND that only those cannabis-related uses authorized pursuant to Chelan County Code Section 11.100 are permitted within Chelan County. All other commercial and noncommercial licensed or registered cannabis uses, including but not limited to cannabis research facilities and medical cannabis cooperatives, are prohibited within all zones of Chelan County. I ACKNOWLEDGE AND UNDERSTAND that pursuant to Chelan County Code Section 11.100 a conditional use permit is required to engage in the production or processing of

cannabis within Chelan County, and that all cannabis producers and processors must register annually with Chelan County and pay the appropriate registration fee. I ACKNOWLEDGE AND UNDERSTAND that it is the responsibility of the property owner to submit for and obtain all necessary development permits and approvals prior to engaging in cannabis-related activities, development, uses or construction, including but not limited to conditional use permits for the production or processing of cannabis, building permits, change of use/occupancy permits, shoreline permits, variances, and mechanical permits. SUB-SECTION III: Please select one of the following: I certify with the signature below that the building or land use permit requested IS NOT related to or in any way supportive of existing or planned cannabis-related activities, development, uses or construction on the property. I further certify that any authorized activities, development, uses or construction WILL NOT be utilized to support or expand cannabis-related activities, development, uses or construction. I certify with the signature below that the building or land use permit requested IS related to or in support of existing or planned cannabis- related activities, development, uses or construction on the property. I certify that any authorized activities, development, uses or construction will be in strict compliance with LCB licensure requirements and all applicable laws and regulations including but not limited to Chelan County Code, Chapter 69.50 RCW (Uniform Controlled Substances Act), Chapter 69.51A (Medical Cannabis), Chapter 19.27 RCW and WAC Title 51 (State Building Code), Chapter 58.17 RCW (Plats-Subdivisions-Dedications), Chapter 90.58 RCW (Shoreline Management Act), Chapter 314.55 WAC, and the Chelan County Shoreline Master Program.

Return Address: Chelan County Department of Community Development 316 Washington St., Suite 301 Wenatchee, WA 98801 For Official Use Only: 1. Staff Only CE Application No.: CE pursuant to Chelan Co. Subdivision Code section(s): 12.14.050 ( ) Type of CE: Receipt No.: Chelan County Application for CERTIFICATE OF EXEMPTION (CE) Owner s Name: Project Address: Mailing Address: City: Home Phone: E-mail Address: State: Business Phone: Zip Code: * Will there be additional names? If so, notation needs to be added. 2. Location of property within Chelan County, WA: Township: Range: Section: 3. Legal Description (abbreviated: i.e. lot, block, and plat or section, township, range): Additional legal is on page of document. 4. Assessor s Parcel Number(s): Page

5. Existing Parcel(s) Information. Provide the following information for each existing tax parcel. Attach additional pages if required. Tax Parcel Number(s) Size (in acres) Zoning Category Comprehensive Plan Designation 6. Special Tax Classification. If you have a special tax classification for any of the parcels listed in item #3, such as Open Space or Timber, then you must answer the following (contact the assessor s office for information): a. In reference to the parcel(s) listed above, the specific tax classification is:. b. Will the new lots meet all of the requirements for this special tax classification? Yes No c. If not, then have you removed these parcels from these optional state-authorized programs? This includes paying any back taxes or penalties. Yes No d. Have you attached to this CE application Evidence of Payment from the County Treasurer for each parcel that is being removed from either of these programs? Yes No 7. Property Use a. Describe existing use of property: b. Describe intended use of property: 8. Access Easements. If you are accessing the lot(s) via an access/road easement (not accessed by a state highway, county road, or an approved private road), you must provide a copy of the recorded access/road easement(s). Please check the box below if a copy is included: Yes, a copy of the recorded access/road easements is included with this application.

9. For Each Proposed Lot(s), Complete the Table(s) Below. Designate the lot number(s), lot size, public road name (if applicable), and legal description(s) for each lot(s).

10. Provide a graphic drawn to scale. All lot line measurements (in feet and inches) must be depicted on this graphic. Label each lot. Show and label existing improvements such as buildings, orchards, wells, septic tanks/drainfields, roads, easements, and any other pertinent features.

11. Signed, Dated, And Notarized Signatures From All Property Owners. I (we), the undersigned, swear under penalty of perjury that I (we) who executed the within and foregoing instrument and accompanying documentation are made truthfully and to the best of my (our) knowledge. I (we) further understand that, should there be any willful misrepresentation or willful lack of full disclosure on my (our) part, Chelan County may withdraw any approval that it might issue in reliance on this application. Further, I (we) understand that by signing below, that upon approval by the Chelan County Department of Community Development and filing with the County Auditor and County Assessor, all new easements and lots will be created as described in this certificate of exemption application. I (we), the owner(s) of all the property described herein do hereby acknowledge and agree to hold Chelan County harmless in any cause of action arising out of the certificate of exemption or recordation of same. Furthermore, I (we), the owner(s) of all the property involved in this certificate of exemption, hereby consent to the proposal in this application. Tax Parcel # Owner (signature) Date Owner (signature) Date ACKNOWLEDGEMENT This is to certify that on the day of, 20 before me, the undersigned, personally appeared To me known to be the person(s), who executed the foregoing statement and acknowledged to me that they signed the same as their free and voluntary act and deed for the uses and purposes therein mentioned. WITNESS my hand and official seal the day and year last above written. NOTARY PUBLIC in and for the State of Washington Residing in: My Commission Expires: Date: