Hardship Exemption Application

HARDSHIP EXEMPTION APPLICATION .._-----------_. __ ._-----_._ ..__ ._._. __ ._. __ ._------_.----ICO Area:

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Effective Date:

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Applicant (Record Owner):

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Telephone:

Applicant Mailing Address

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Lot Area (sq. ft.):

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Note: A Master Land Use Application

Page 3 of5

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is not required.

OCT 0 7 2008

PLANNING & LAND USE MANAGEMENT

Describe Proposed Project and Use (Include size in square feet, height, etc.):

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Why do you believe a hardship exists for which an exemption should be granted? a separate sheet if necessary. An economic analysis may also be submitted.)

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(Attach a statement on

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Do you have any ownership interest in any other parcels within 300 feet of this property? ( )Yes ( (If yes, submit a map showing the location and boundaries of the property for which an exemption is being requested, and the location of the other ownerships.)

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) No

ADDITIONAL INFORMATION FILING REQUIREMENTS In addition to this form, all below items should be included with the application, unless otherwise instructed by City Staff. a.

Attach a map showing the location and boundaries of the property for which the exemption is being requested. (May be the same map as required in No.7)

b.

Attach a Plot Plan showing the building footprint, parking plan, landscaping, balconies, driveways, any amenities, etc.

c.

Attach an Elevation Plan, which includes dimensions for all views.

d.

Attach Building Plans. If plans have been accepted by the Department of Building and Safety, list Plan Check No. and Submittal Date _

e.

Submit a Project History summary that includes dates and descriptions of meetings, negotiations, expenditures, commitments, etc.

f.

Submit Photographs of the subject property and all surrounding property - not over 8 Y, x 11 inches, but of adequate size to illustrate the condition and physical context of the property under discussion.

g.

Attach any additional

information

as needed.

Note: A Master Land Use Application

Page 4 of5

is not required.

M"'TlrlN IS TRUE AND CORRECT TO THE

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OF MY KNOWLEDGE.

Date

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Representative

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Proof of ownership will be required at the time of application submittal. A recorded grant deed and/or City Clerk's ownership records printout are acceptable.

Note: A Master Land Use Application is not required.

Page 50f5

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• Why a hardship exists for which an exemption should be granted: Advanced Patient's Collective (APC) qualifies for an exemption because it meets the requirements for a hardship exemption. APC's business license dates back to 2005 and APC successfully filed for the pre-moratorium permit in September of2007(attached). APC is being forced to move by means of pressure placed upon its current landlord in the form of the DEA's unscrupulous threat letter. We are relocating just several blocks from our prior location, the same area we have always been with no other licensed collective existing in the same immediate area. We strongly prohibit any redistribution of medicine and enforce a policy of permanent loss of access to any patient observed doing so. We strictly enforce all patient documentation requirements and regularly verify all patient documentation.

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Advanced Patient's Collective has always been a tax paying, guideline following collective. Working with Dr. Michael Engleberg of Cedar Sinai's Cancer Center we have been taking care of patients of all status: Veteran, SSI, SDI, low income and terminal illness. We work with Los Angeles Police Department Senior Lead Officer Danny Pesqueria to make sure our facility and patient care methods are safe and secure and criminal free. We follow all the guidelines of the California health and safety code section 11362.5(b) (1) (a) and 11362.7(h) as well as the guidelines recently issued by the state attorney general. These are the qualifying reasons for a hardship exemption as dictated by the city ordinance pertaining to our business.

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MEDICAL MARIJUANA DISPENSARY BUSINESS INFORMATION FORM

Telephone Number

(373) LjbY-6Lj6S

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Street Address, Unit #

(500 60WD?- ST,

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City, State, Zip

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Business Owner

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Fill out the information form above and attach the following documents.

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City of Los Angeles Tax Registration Certificate

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State Board of Equalization seller's permit

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Property lease or documentation of ownership

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Business insurance

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Dispensary membership forms (blank)

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2007 SUo I 9 r;. 2: C 3

Los A geles County Health Department permit (if needed)

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I certify that to the best of my knowledge and under the penalty of perjury, that the information contained on this Medical Marijuana Dispensary Business Information Form is correct. I further certify that to the best of my knowledge and under the penalty of perjury, that attached documents are correct and true.