Marijuana Medical Application - Muskegon Township

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Marihuana Medical Application

The form will be submitted to bwerschem@muskegontwp.org

$5,000 Annual License Fee required to accompany application

Action(Required)

New License

Renewal

Transfer of Ownership

License Requested(Required)

Provisioning Center

Secure Transport

Safety Compliance Facility

Processor

Grower

Class

Class A (500 Plants or as amended by the Act)

Class B (1,000 Plants or as amended by the Act)

Class C (1,500 Plants or as amended by the Act)

Applicant(Required)

First Last

Applicant Address(Required)

Street Address Address Line 2 City State ZIP Code

Applicant Phone(Required)

Email(Required)

Property Address(Required)

Street Address Address Line 2 City State ZIP Code

Property Parcel #(Required)

Current Zoning(Required)

Size of Plot in Acres(Required)

List All Owners with any level of interest in the property or in the business. (Copies of valid drivers license must accompany application for required background check). I (we) hereby swear and attest that I (we) are the owners of the above parcel of property and the information is true and accurate to my (our) knowledge.

Name(Required)

Date(Required)

MM slash DD slash YYYY

Name

Date

MM slash DD slash YYYY

Name

Date

MM slash DD slash YYYY

Name

Date

MM slash DD slash YYYY

Name

Date

MM slash DD slash YYYY

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Township Hall

Address:
1990 E. Apple Ave
Muskegon, MI 49442

Hours:
Monday – Thursday: 7:30 am – 6:00 pm
closed for lunch from 1:00 to 1:30
Fridays by appointment only

Contact Us

Phone:
(231) 777-2555

Fax:
(231) 777-4912

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