W. Va. Code R. § 65-29-4

Current through Register Vol. XLI, No. 36, September 6, 2024
Section 65-29-4 - Application

An application for an exemption shall, at a minimum, include the following:

4.1.a. Name, address, and contact information for the applicant;
4.1.b. Name, address, and contact information for the person making the application;
4.1.c. Verifications from the person making the application and the CEO of the applicant entity;
4.1.d. A copy of the governing body's written authorization empowering the CEO or his or her designee to authorize specified individuals to sign the application and to act on its behalf; and
4.1.e. A detailed description of the project, including but not limited to:
4.1.e.1. The location of the proposal;
4.1.e.2. A detailed statement of the services to be provided;
4.1.e.3. The exemption for which the applicant is applying with the appropriate Code citation;
4.1.e.4. A statement of the circumstances justifying approval of the exemption; and
4.1.e.5. A timetable for implementation of the project. In the case of a kidney disease treatment center, the facility must be operational within one year of the approval or the exemption will expire after one year.
4.1.f. In the case of an exemption of a kidney disease treatment center, the application shall also contain:
4.1.f.1. The address of the proposed facility and a copy of the executed lease or option to lease or option to purchase agreement for the facility; and
4.1.f.2. Evidence that there is adequate water and other utilities at the site to support the facility.

W. Va. Code R. § 65-29-4