Department Cannabis Regulations – CEQA LIC-4013 Project Specific Information Form, cont.

Thank you for trusting CH Compliance to help you prepare this important document so you can renew your City Of Los Angeles License for 2024.

The information that we will need from you to get started right away is for you to choose one of these Categorical Exemptions below. Most City of Los Angeles Licensees will belong in Class 1. Based on your Class we will be able to proceed with the 23 page document required by DCR.

Class #

Name

First Name

Last Name

Phone

Country

(###)

###

####

DCR License No.

License Type

Business Premises Location

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Assessor’s Parcel Number (APN)

Please book a time to call and speak to Nicole for the rest of the information needed here

** This form only needs to be completed once in the lifetime of the license **