Clearlake, CA · Lake County
Application for Garbage Service Exemption
Residential property owners submit this application to request an exemption from Clearlake’s solid waste service requirement based on the conditions listed on the form.
What this form is
Clearlake residential property owners use this application to request an exemption from subscribing to solid waste services. The form asks for the property address and assessor’s parcel number, the applicable exemption conditions, comments, and owner contact and signature details. An exemption is valid for one year, requires annual reapplication, and requires a death certificate copy when the owner is deceased and the property is vacant.
Who needs it
A residential property owner who believes the property meets one or more exemption conditions listed on the form should submit this application.
How to submit it
Return or mail the completed form to the City of Clearlake at 14050 Olympic Dr, Clearlake, CA 95422, as stated on the form.
About notarization
This document is signed without a notary; the owner certifies the claims under penalty of perjury, and a death certificate copy is required for one listed condition.
How to submit this form
- 1
Download the Application
Download the garbage service exemption application for Clearlake.
- 2
Complete the Form
Provide the property address and assessor’s parcel number, check all applicable conditions, and enter comments and owner contact information.
- 3
Gather Required Attachment
If the owner is deceased and the property is vacant, include a copy of the death certificate.
- 4
Sign and Submit
Sign and date the application, then return or mail it to 14050 Olympic Dr, Clearlake, CA 95422.
Frequently asked questions
- Do I need a notary for the garbage exemption application?
- No. The application has an owner signature and date line, but no notary block. The owner certifies the claims under penalty of perjury; a death certificate copy is required if the deceased-owner condition applies.
- Who can apply for a garbage service exemption?
- The form is for residential property owners who believe one or more listed conditions apply, such as the property being undeveloped or generating no solid waste.
- How do I submit the garbage exemption application?
- Return or mail the completed form to the City of Clearlake at 14050 Olympic Dr, Clearlake, CA 95422. Include a death certificate copy if applying because the property owner is deceased and the property is vacant.
- How long does an approved exemption last?
- The form says approval is valid for one year. The property owner must reapply annually, no later than one year after approval or sooner if requested by the city.
Need something notarized?
This Application for Garbage Service Exemption doesn’t need a notary — but if you have another Clearlake form that does, a commissioned online notary can help.