2. 

3. Marihuana Business Permit Application

   (City Codified Ordinance - Chapter 11)
   https://library.municode.com/mi/taylor/codes/code_of_ordinances?nodeId=PTIICOOR_CH11MACOBU

5. Applications submitted before 12 am, October 1, 2023, will be considered invalid
7. Please read the list of documents required prior to starting your application
   Documents Required for Submission
9. If the establishment requires a variance, it must be approved prior to applying for the marihuana business permit
   Zoning Board of Appeals Application

11. Applicant Information (person signing the application)

13. Full Name*
15. Relationship to Business (ex. owner, member, partner, manager, etc.)*
17. Residence Address*
18. City*
19. State*
20. Zip Code*
22. Business Address*
23. City*
24. State*
25. Zip Code*
27. Applicant Phone Number*
28. Business Phone Number*
30. Date of Birth*
    Date of Birth
31. Email Address*

35. Type of Permit Requested

    Medical

37. Grower*

    1. Class A (500 plants)
    2. Class B (1,000 plants)
    3. Class C (1,500 plants)

    1. Processor
    2. Safety Compliance
    3. Provisioning Center

    1. Secure Transporter
    2. N/A
39. No. of Class C Permits*
41. Adult Use
43. Grower*

    1. Class A (100 plants)
    2. Class B (500 plants)
    3. Class C (2,000 plants)

    1. Excess Grower
    2. Processor
    3. Safety Compliance

    1. Retailer
    2. Secure Transporter
    3. N/A
45. No. of Class C Permits*

49. Proposed Facility Information

51. Advertised Facility Name*
52. Property Zoning District*
    -- Select One --I1- Light Industrial I2- General Industrial
54. Property Address*
55. Real Property Parcel Number*
57. Manager - Full Name*
58. Manager - Phone Number*
60. Manager - Email Address*

64. Property Owner(s) Information

66. Full Name*
67. Phone Number*
69. Address*
70. City*
71. State*
72. Zip Code*
74. Email Address*
76. Are there additional property owners? *

    You must provide information for each property owner

    1. Yes
    2. No
80. Full Name*
81. Phone Number*
83. Address*
84. City*
85. State*
86. Zip Code*
88. Email Address*
90. Are there additional property owners?*

    1. Yes
    2. No
92. If yes, please submit a document listing the requested information above for each additional owner.*

96. Business Information

98. Ownership Type*

    1. Individual/Sole Proprietorship
    2. Sole Member LLC
    3. LLC

    1. Partnership
    2. Corporation
    3. Other
99. If corporation, what type:*
100. Other (please specify)*
102. Official Business Name*
104. Business Address*
105. City*
106. State*
107. Zip Code*
109. Business Phone Number*
110. Business Email Address*
112. Business Website*
113. Federal Tax ID Number (if not applicable type "N/A"):*
115. Provide the following information for the Individual, Sole Proprietor or Sole Member*

     1. I understand
117. Full Name*
119. Residence Address*
120. City*
121. State*
122. Zip Code*
124. Business Address*
125. City*
126. State*
127. Zip Code*
129. Business Phone Number*
130. Date of Birth*
     Date of Birth
132. Email Address*
134. Does the Individual/Sole Proprietorship or Sole Member LLC have a spouse? *

     1. Yes
     2. No
136. Provide the following information for the spouse of the Individual, Sole Proprietor, or Sole Member.*

     1. I understand
138. Full Name of Individual, Sole Proprietor or Sole Member's Spouse*
140. Residence Address*
141. City*
142. State*
143. Zip Code*
145. Business Address*
146. City*
147. State*
148. Zip Code*
150. Business Phone Number*
151. Date of Birth*
     Date of Birth
153. Email Address*
155. Complete this section for every "Applicant" as defined in the Code of Ordinances, Chapter 11. If additional space is needed, you will be asked to attach a seperate document listing this information for each additional applicant.*

     1. I understand
157. Full Name*

     This section must be completed for every "Applicant" as defined in the Code of Ordinances, Chapter 11. 

158. Date of Birth*
     Date of Birth
160. Residence Address*
161. City*
162. State*
163. Zip Code*
165. Phone Number*
166. Email Address*
168. Do you have another "Applicant" to add? *

     1. Yes
     2. No
172. Full Name*
173. Date of Birth*
     Date of Birth
175. Residence Address*
176. City*
177. State*
178. Zip Code*
180. Phone Number*
181. Email Address*
183. Do you have another "Applicant" to add? *

     1. Yes
     2. No
187. Full Name*
188. Date of Birth*
     Date of Birth
190. Residence Address*
191. City*
192. State*
193. Zip Code*
195. Phone Number*
196. Email Address*
198. Do you have another "Applicant" to add? *

     1. Yes
     2. No
202. Full Name*
203. Date of Birth*
     Date of Birth
205. Residence Address*
206. City*
207. State*
208. Zip Code*
210. Phone Number*
211. Email Address*
213. Do you have another "Applicant" to add? *

     1. Yes
     2. No
217. Full Name*
218. Date of Birth*
     Date of Birth
220. Residence Address*
221. City*
222. State*
223. Zip Code*
225. Phone Number*
226. Email Address*
228. Do you have another "Applicant" to add? *

     1. Yes
     2. No
230. Upload here if additional space is needed:*
234. Additional Documents Required

     In order for this application to be complete, you must also submit the following documents:

236. APPLICANT'S GOVERNMENT ISSUED PHOTO ID ( i.e. DRIVER'S LICENSE)

     Please attach a copy of each applicant's government issued ID. You will need to scan them into one file to upload.

238. PROOF OF CORPORATION REGISTRATION (if applicable)
240. PROOF OF PRE-QUALIFICATION STATUS FROM STATE OF MI*
242. DEED/LEASE/PURCHASE AGREEMENT*
244. PROPERTY OWNER'S AFFIDAVIT- NOTARIZED (if applicable)- THE ORIGINAL WILL NEED TO BE SUBMITTED TO THE CLERK'S OFFICE
246. DESCRIPTION OF PROPOSED OPERATIONS*
248. DIAGRAM OF PROPOSED LICENSED PREMISE*
250. PHOTOMETRIC LIGHTING PLAN, IN COMPLIANCE WITH 16.05 OF THE CITY OF TAYLOR ZONING ORDINANCE*
252. PROOF OF LOCATION MEETING CRITERIA AS OUTLINED IN ARTICLE 11, SIGNED AND STAMPED BY A LICENSED ENGINEER/SURVEYOR- THE ORIGINAL WILL NEED TO BE SUBMITTED TO THE CLERK'S OFFICE*
254. PROOF OF INSURANCE AS OUTLINED IN THE CODE OF ORDINANCES, CHAPTER 11

     *Required after provisional certificate is issued. May be submitted now if available.

256. SECURITY PLAN

     *Required after provisional certificate is issued. May be submitted now if available.

258. STAFFING PLAN

     *Required after provisional certificate is issued. May be submitted now if available.

260. SIGNATURE PAGE- NOTARIZED- THE ORIGINAL WILL NEED TO BE SUBMITTED TO THE CLERK'S OFFICE

     This can be notarized at the City Clerk's office when original documents are submitted. The notary fee is $10.00 per notarization. 

261. Signature page needing notarization
     Click here to view the form

     Print and complete form with a notarized signature. Upload a copy and return the original to the Clerk's office. 

263. 1. Neither I, nor any "Applicant" is in default to the City of Taylor for any property tax, special assessment, utility charges, fines, fees or other financial obligation owned to the City of Taylor.
     2. I the applicant have reviewed and agree to conform its hiring and public accommodation practices to the City of Taylor’s anti-discrimination ordinance provisions.
     3. Neither I, nor any “Applicant” is ineligible from holding a license for any reasons set forth in the MMFLA and its administrative rules, the MRMTA and its administrative rules, or Chapter 11 of the Taylor City Code.
     4. I the applicant consent to inspections, examinations, searches and seizures required or undertaken pursuant to enforcement of Chapter 11 of the Taylor City Code.
     5. I agree to report any changes to the information required under Chapter 11 to the City Clerk within ten (10) business days.
     6. I understand that I must be licensed by the State of Michigan before I am eligible to apply for a permit with the City of Taylor, I further understand that I must adhere to and comply with all terms listed under the Chapter 11, Marihuana Commercial Business, Article 11 of the Zoning Code, Chapter 10 Business Licensing, and any other applicable ordinance.
Leave This Blank:


265. 1. Receive an email copy of this form.
266. Email address

     This field is not part of the form submission.

267. Submit Submit and Print

* indicates a required field