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WISE TOWNSHIP

ISABELLA COUNTY, MICHIGAN

Fee: $5,000.00 per permit requested

Transfer Fee- non-operating $500. Operating-$2,500 per permit.

Application For Permit - Commercial Medical Marihuana Facility Or Adult Use Marihuana Establishments

Date*

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Application for (check one):*

New permit for Commercial Medical Marihuana Facility (“CMMF”)

New AUME (recreational)

Transfer of permit for CMMF or AUME

Applicant(s) Information

In addition to the information required below, the names, home addresses, and personal phone numbers for all owners, directors, officers, and managers of the proposed CMMF or AUME are required and must be attached to this application

Name

Address Title*

Recipient

Address line one

Address line two

Address line three

Country

Province

Postal Code

Phone

Email Address

Legal Interest in Subject Property

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Subject Property Owner

Name

Address Title*

Recipient

Address line one

Address line two

Address line three

Country

Province

Postal Code

Phone

Email Address

Address of Subject Property:

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Parcel Identification Number

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Number of Each

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Number of Each

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Proposed CMMF or AUME will operate within *

(check one):

A structure or structures pre-existing on the Subject Property

A structure or structures to be erected pending issuance of a Permit

A combination of structures pre-existing on the Subject Property and structures to be erected pending issuance of a Permit

Before the Township will consider the Application for a CMMF or AUME Permit, the Applicant(s) must compete this application form, pay all fees and attach ALL of the following documentation:

If the proposed Permit Holder is a corporation, non-profit organization, limited liability Company or any other entity other than a natural person, attach all of the following:*

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Documentation indicating its legal status

Copy of all company formation documents (including amendments)

Proof of registration with the State of Michigan

Certificate of good standing

Upload Files (Any type)

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Max file size: 50.00 MB. | Allowed file types: gif,jpeg,png,jpg,csv,doc,docx,xls,xlsx,ppt,xml,pdf

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All documentation showing the proposed Permit Holder’s valid tenancy, ownership or other legal interest in the proposed Permitted Property and Permitted Premises. If the Applicant is not the owner of the proposed Permitted Property and Permitted Premises, a notarized statement from the owner of such property authorizing the use of the property for a CMMF or AUME.

Upload the following information in the UPLOAD box provided *

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Copies of a valid, unexpired driver’s license or state issued ID for all owners, directors, officers and managers of the proposed Facility.

Evidence of a valid sales tax license for the business if such a license is required by state law or local regulations.

An identification of any business that is directly or indirectly involved in the growing, processing, testing, transporting or sale of Marihuana or the Facility

A statement indicating whether any Applicant has ever applied for or has been granted any commercial license or certificate issued by a licensing authority in Michigan or any other jurisdiction that has been denied, restricted, suspended, revoked, or not renewed and a statement describing the facts and circumstances concerning the application, denial, restriction, suspension, revocation, or nonrenewal, including the licensing authority, the date each action was taken, and the reason for each action.

A site plan and interior floor plan of the Permitted Premises and the Permitted Property signed and sealed by a Michigan registered architect, surveyor or professional engineer.

A statement providing information regarding any other CMMF that the Applicant(s) is authorized to operate in any other jurisdiction within the State, or another State, and the Applicant(s) involvement in each Facility.

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Max file size: 50.00 MB. | Allowed file types: gif,jpeg,png,jpg,csv,doc,docx,xls,xlsx,ppt,xml,pdf

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Business and Operations Plan, showing in detail the CMMF’s or AUME proposed plan of operation, including without limitation, the following:*

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A security plan meeting the requirements of Wise Township Ordinance Authorizing and Permitting CMMFs or AUME’s.

A description of the type of Facility proposed and the anticipated or actual number of employees.

A description by category of all products to be sold

A list of Material Safety Data Sheets for all nutrients, pesticides, and other chemicals proposed for use in the CMMF or AUME

A description and plan of all equipment and methods that will be employed to stop any impact to adjacent uses, including enforceable assurances that no odor will be detectable from outside of the Permitted Premises.

A plan for the disposal of Marihuana and related byproducts that will be used at the Facility.

Applicant(s) and Owner(s) Certification:

Applicant(s) and Owner(s) certify that the Information submitted in and attached to this application is true and correct to the best of their knowledge. Applicant(s) and Owner(s) acknowledge and agree that: (1) they are required to supplement the information submitted in and attached to this application when required, and within (10) days ,under the Wise Township Ordinance Authorizing and Permitting CMMFs; (2) it is their sole responsibility to comply with the requirements of any applicable Wise Township Ordinance, notwithstanding the signature or approval of any Township employee(s) or official(s); (3) Wise Township is not bound to recognized the approval or other action of any employee(s) or official(s) that is not in strict compliance with the applicable Wise Township Ordinance; and (4) the and resulting permit do not give the Applicant(s) or Owner(s) any vested rights to any permit or to any renewal.

Signature (Applicant)

Type Name

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Signature (Applicant)

Type Name

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Signature (Applicant)

Type Name

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Signature (Applicant)

Type Name

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WISE TOWNSHIP

Application For Permit - Commercial Medical Marihuana Facility Or Adult Use Marihuana Establishments

Upload Files (Any type)

Upload Files (Any type)

Applicant(s) and Owner(s) Certification:

Signature (Applicant)

Signature (Applicant)

Signature (Applicant)

Signature (Applicant)

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