HomeMy WebLinkAboutCombined Cannabis Packet Updated 2122024City of Palm Desert
Department of Development Services
73510 Fred Waring Drive, Palm Desert, CA 92260
760-837-1680, email: cannabisregulatory@palmdesert.gov
Commercial Cannabis Business Regulatory Permit Application
New Business Renewal Change of Location Change of Operation Change of Ownership
Update Contact Information
CONDITIONAL USE PERMIT AND RESOLUTION No.
APPLICANT NAME:
Mailing Address:
City: State: Zip Code:
Email: Telephone:
COMMUNITY RELATIONS MANAGER:
Cell: Primary Telephone:
Email:
PROPERTY OWNER / LANDLORD NAME:
Mailing Address: City: Zip Code:
Phone: Cell: Email: _________________________
24-Hour Emergency Contact:
Name: Email:
Phone(1st): Phone(2nd):
COMMERCIAL CANNABIS BUSINESS PERMIT (TYPE) Please select from the categories:
Cultivation / Cultivation Square Footage: Distribution Manufacturer
Microbusiness (Please identify all business activities:
Retailer Retailer to Include Delivery Testing Non-Storefront to Include Delivery
BUSINESS INFORMATION:
Secretary of State Statement of Information No.:
“Doing Business As”:
Business Email Address (if applicable): Phone:
Type of Business Entity:
State Cannabis License No.: Expiration:
Palm Desert License No.: Expiration:
Total Square footage: Insurance Policy Name and Expiration Date:
Project Address / Location:
Assessor’s Parcel Number (APN):
Applicant/Representative: By signing this application, I certify that the information is accurate. I understand that the City
might disapprove of what I am applying for and/or require approval conditions.
Signature Print Name Date
City of Palm Desert
Department of Development Services
73510 Fred Waring Drive, Palm Desert, CA 92260
760-837-1680, email: cannabisregulatory@palmdesert.gov
Commercial Cannabis Regulatory List of Requirements
1
Important note when applying: Please separate the Financial and Security Plans by placing a
cover sheet on the subject. These sensitive and confidential documents will be stored
separately in a safeguard folder on the City’s server.
I. PURPOSE: Introduction
In coordination with reviewing a Conditional Use Permit application and as a continued
requisite to operate a commercial cannabis business, all cannabis business operators must
apply annually for the Cannabis Regulatory Permit. This permit w ill be issued to the
applicant of the cannabis business only and is required to remain valid during business
operations. Any lapse in permit activity will result in revocation and cessation of the
cannabis business.
II. SUBMITTAL REQUIREMENTS: Application
1. Regulatory Permit Form completed with required signatures.
2. Required documents, exhibits, and plans as described in P.D.M.C Chapter 5.101 and
below.
III. PROCEDURE: Conditional Use Permit & Resolution
Initially, a Cannabis Regulatory Permit must be applied for along with the Conditional Use Permit
(CUP) application for all commercial cannabis businesses. Once the City’s Planning Commission
approves a CUP, the Business License Division of the Community Development Department will issue
a Cannabis Regulatory Permit. The permit is issued to the business owner or operator only. Any
business ownership changes will require a new or amended Cannabis Regulatory Permit. In addition,
a Cannabis Regulatory Permit is valid for one (1) year and must be applied for annually along with a
Business License.
IV. APPLICATION CHECKLIST:
Applicants are required to provide the following information when applying for a Cannabis
Regulatory Permit:
1. Business Legal Documents - A description of the statutory entity or business form that will serve
as the legal structure for the applicant and a copy of its formation and organizing documents,
including, but not limited to, articles of incorporation, certificate of amendment, statement of
information, articles of association, bylaws, partnership agreement, operating agreement, and
fictitious business name statement.
2. Applicant’s Identification - A legible copy of each applicant’s photo identification, such as a state
driver’s license, a passport issued by the United States, or a permanent resident card.
3. Licenses & Permits Issued - A list of the license or permit types (including license or permit
numbers) held by the applicant that involve the operation of a commercial cannabis business,
City of Palm Desert
Department of Development Services
73510 Fred Waring Drive, Palm Desert, CA 92260
760-837-1680, email: cannabisregulatory@palmdesert.gov
Commercial Cannabis Regulatory List of Requirements
2
including the date the license or permit was issued and the jurisdiction or State license authority
that issued the license or permit.
4. Licenses & Permits Denied - Whether the applicant has been denied a license or permit by the
City, any other jurisdiction, and/or the State that involves the operation of a commercial
cannabis business. The applicant shall describe the license or permit applied for, the name of
the jurisdiction or State license authority that reviewed the license or permit application, and
the date of denial.
5. Business Contact Info - The proposed commercial cannabis business’s physical address,
telephone number, website address, and e-mail address.
6. Applicant’s Owned Business(s) - A list of every fictitious business name the applicant is operating
under, including the address of the business.
7. Financial - Financial information including the following:
a. Financial Funds - A list of funds from the commercial cannabis business held in a financial
institution's savings, checking, or other accounts. The applicant shall provide for each
account the financial institution’s name, the financial institution’s address, account
type, account number, and the amount of money in the account.
b. Financial Loans – A list of loans made to the commercial cannabis business. For each
loan, the applicant shall provide the loan amount, the loan's date, the loan's term(s),
the security provided for the loan, and the lender's name, address, and phone number.
c. Financial Investments - A list of investments made into the commercial cannabis
business. For each investment, the applicant shall provide the investment amount, the
investment date, the investment term(s), and the investment entity name, address, and
phone number.
d. Financial Gifts - A list of any gifts given to the applicant for its use in conducting
commercial cannabis business. For each gift, the applicant shall provide the value of the
gift or description of the gift and the provider's name, address, and phone number.
8. Applicant’s Criminal History - A list of each applicant’s misdemeanor and felony convictions, if
any. For each conviction, the list must set forth the date of arrest, the offense charged, the
offense convicted, the jurisdiction of the court, and whether the conviction was by verdict, plea
of guilty, or plea of nolo contender.
9. Site and Floor Plan - A complete and detailed diagram of the proposed premises showing the
boundaries of the property and the proposed premises to be permitted, showing all boundaries,
dimensions, entrances and exits, interior partitions, walls, rooms, windows, doorways, and
common or shared entryways, storage areas, and exterior lighting. The diagram must show the
areas in which all commercial cannabis business will take place, including but not limited to
limited-access areas.
City of Palm Desert
Department of Development Services
73510 Fred Waring Drive, Palm Desert, CA 92260
760-837-1680, email: cannabisregulatory@palmdesert.gov
Commercial Cannabis Regulatory List of Requirements
3
10. Security Plan - A security plan, as a separate document, outlining the proposed security
arrangements to deter and prevent unauthorized entrance into limited access areas and theft
of cannabis in accordance with minimum security measures required by state law and measures
identified in Section 5.101.040(M) of the Palm Desert Municipal Code. The Palm Desert Police
Department and the City Manager shall review the security plan. It shall be exempt from
disclosure as a public record pursuant to Government Code Section 6255(a).
11. Business Operations - A comprehensive business operations plan that includes the following:
a. Business plan. A plan describing how the commercial cannabis business will operate in
accordance with this code, state law, and other applicable regulations. The plan shall
include operational, banking, and personnel procedures to ensure adequate business
knowledge, modeling, and support.
b. Community relations plan. A plan describes who is designated as responsible for
outreach and communication with the surrounding community, including the
neighborhood and businesses, and how the designee can be contacted.
c. Neighborhood responsibility plan. A plan addressing any adverse impacts of the
proposed commercial cannabis business on the surrounding area.
d. Odor control plan. A plan identifying odor control methods, including, but not limited
to, the use of odor-absorbing ventilation and exhaust systems, negative air pressure,
and other treatments.
e. Insurance. The applicant’s certificate of commercial general liability insurance and
endorsements and certificates of all other insurance related to the operation of the
commercial cannabis business.
f. Budget. A copy of the applicant’s most recent annual budget for operations.
12. Property Owner’s Authorization (notarization) - The name and address of the owner and lessor
of the real property upon which the commercial cannabis business will be operated. If the
applicant is not the legal owner of the property, the application must be accompanied by a
notarized acknowledgment from the property owner that a commercial cannabis business will
be operated on his or her property.
13. Verification Authorization - Authorization for the city manager to seek verification of the
information contained within the application.
14. Applicant’s Certification (notarization) - A written statement by the applicant that he or she
certifies under penalty of perjury that all the information in the application is true and correct.
15. Applicant’s State Licenses - A complete copy of the applicant’s most current application
submitted to and approved by the applicable State licensing authority (only applicable on a
renewal basis).
City of Palm Desert
Department of Development Services
73510 Fred Waring Drive, Palm Desert, CA 92260
760-837-1680, email: cannabisregulatory@palmdesert.gov
Commercial Cannabis Regulatory List of Requirements
4
16. Interest Parties - The name, address, telephone number, title, and function of each of the
interested parties described below:
a. Interest Parties Contact Info - A permittee shall provide the City with the names and
addresses of all of the following interested parties:
i. Investor’s 10%+ - Persons with at least a 10% interest in the commercial
cannabis business;
ii. Owner’s 10%+ - Partners, officers, directors, and stockholders of every
corporation, limited liability company, or general or limited partnership that
owns at least 10% of the stock, capital, profits, voting rights, or membership
interest of the commercial cannabis business or that is one of the partners in
the commercial cannabis business; and
iii. Employee Contact Info - The managers of the commercial cannabis business and
the staff of the commercial cannabis business.
b. Interest Parties Background & Fingerprinting - All interested parties, as described in the
subsections listed above, must submit to fingerprinting and a criminal background check
by the city.
c. Interest Parties No Criminal History - No person shall be an interested party, as
described in subsection A of this Chapter 5.101 of the Palm Desert Municipal Code
(PDMC), if he or she is charged with or convicted of a felony; has been charged with or
convicted of a violation of California Penal Code section 186.22 (participation in a
criminal street gang); or is currently on parole or probation for an offense relating to the
sale or distribution of a controlled substance. “Convicted” within the meaning of this
section means a plea or verdict of guilty or a conviction following a plea of nolo
contendere was entered but does not include any plea, verdict, or conviction that is
expunged pursuant to California law or a similar federal or state law where the
expungement was granted. “Charged” within the meaning of this section means (1) a
grand jury issued an indictment, or information, complaint, or similar pleading was
issued by the United States Attorney, district attorney, city attorney, or other
governmental official or agency authorized to prosecute crimes, and (2) the criminal
proceedings are currently pending.
City of Palm Desert
Department of Development Services
73510 Fred Waring Drive, Palm Desert, CA 92260
760-837-1680, email: cannabisregulatory@palmdesert.gov
Commercial Cannabis Regulatory Permit Application
PROPERTY OWNER CONSENT - AUTHORIZATION FORM
If the Applicant is other than the property owner(s), the owner(s) must provide a signed and
notarized statement consenting to filing pursuant to Section 5.101 of the City of Palm Desert
Municipal Code. Additional sheets may be attached if necessary. Original signatures only.
I/We, as the owner(s) of the subject property, consent to the filing of this application and use of
the property for the purposes described herein. We further consent and hereby authorize City
representative(s) to enter upon my property for the purpose of examining and inspecting the
property in preparation of any reports and/or required environmental review for the processing
of the application(s) being filed.
Print Name Signature
Title Date
Print Name Signature
Title Date
Print Name Signature
Title Date
ATTACHMENT: CALIFORNIA ACKNOWLEDGEMENT
Commercial Cannabis Regulatory Permit Application
A notary public or other officer completing this certificate verifies only the identity of the individual who
signed the document to which this certificate is attached and not the truthfulness accuracy or validity of
that document.
State of }
County of }
On before me, , a Notary Public,
personally appeared who proved to me on
the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument
and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and
that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the
person(s) acted, executed the instrument.
I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is
true and correct.
WITNESS my hand and official seal.
____________________________
Signature of Notary Public Place Notary Seal and/or Stamp Above
City of Palm Desert
Department of Development Services
73510 Fred Waring Drive, Palm Desert, CA 92260
760-837-1680, email: cannabisregulatory@palmdesert.gov
Commercial Cannabis Regulatory Permit Application
Statement of Authorization to Indemnify City
Indemnity:
The undersigned, on behalf of
(Name of Corporation (“Applicant”)
hereby authorizes and agrees to indemnify the City of Palm Desert (the “City”), its agents, officers, and
employees, to the maximum extent permitted by law, as such may be amended from time to time, and to defend
at its sole expense, any and all action against the City, its agents, officers, and employees because of any and all
issues relating to the approval of said commercial cannabis facility and related Ordinance(s) in the City.
Reimbursements:
The undersigned, on behalf of
(Name of Corporation (“Applicant”)
also agrees to reimburse the City for any court costs and attorney fees that the City may incur as payment for
such action. The City may select any attorney it deems appropriate in the City’s exclusive discretion. As set forth
herein, reimbursement of costs and fees shall be made payable to the “City of Palm Desert” within thirty (30)
days of a written request. Failure of “Applicant” to make payment of reimbursement, as set forth herein, shall
be grounds for revocation of a permit to operate a commercial cannabis facility in the City.
Declaration of Authorized Agent(s):
This form MUST be signed by each owner/shareholder or managing member of the “Applicant.” I declare under
penalty of perjury that I have read the forgoing application and all information, statements, verifications,
declarations, and authorizations made, attached to and contained herein, that I have personal knowledge of the
information contained in the application, and that the information contained in the application is true and
correct, and that we/I am duly authorized to enter into this Indemnity on behalf of “Applicant.”
Printed Name & Title Signature of Management Member Date
Printed Name & Title Signature of Management Member Date
Printed Name & Title Signature of Management Member Date
City of Palm Desert
Department of Development Services
73510 Fred Waring Drive, Palm Desert, CA 92260
760-837-1680, email: cannabisregulatory@palmdesert.gov
Commercial Cannabis Regulatory Permit Application
Statement of Authorization to Reimburse the City of Palm Desert
The undersigned, on behalf of ,
(Name of Corporation “Applicant”)
hereby agrees to fully reimburse the City of Palm Desert for any and all costs the City of Palm Desert may incur
as a result of the existence of commercial cannabis facilities in the City of Palm Desert and the implementation
of Palm Desert Municipal Code Chapter 5.101.
The undersigned, on behalf of ,
(Name of Corporation “Applicant”)
also agrees to provide the City with revenue to offset the potential deleterious effects of the location of the
Commercial Cannabis Facility.
This form MUST be signed by each “Applicant” Management Member.
Printed Name & Title Signature of Management Member Date
Printed Name & Title Signature of Management Member Date
Printed Name & Title Signature of Management Member Date
I declare under penalty of perjury that I have read the forgoing application and all information, statements,
verifications, declarations, and authorizations made, attached to an contained herein, and that I have personal
knowledge of the information contained in the application, and that the information contained in the application
is true and correct, and that the application was completed under the supervision of the Management Members.
Executed this day of 20 , at .
City and State
City of Palm Desert
Department of Development Services
73510 Fred Waring Drive, Palm Desert, CA 92260
760-837-1680, email: cannabisregulatory@palmdesert.gov
Commercial Cannabis Regulator Permit Application
Applicant Certification – Authorization Form
I, hereby certify, under penalty of perjury, on behalf of myself and all owners, managers, and supervisors
identified in this application, that the statements and information furnished in this application and in the
attached exhibits present the data and information required for this initial evaluation to the best of my
ability, and that the facts, statements and information presented are true and correct to the best of my
knowledge and belief. I understand that a misrepresentation of fact is the cause for the rejection of this
application, denial of the permit, or revocation of a permit issued.
In addition, I understand that filing this application permits the City of Palm Desert to reproduce submitted
materials, including but not limited to plans, exhibits, and photographs, for distribution to staff,
Commission, Board and City Council Members, and other Agencies to process the application. Nothing in
this consent, however, shall entitle any person to use the intellectual property in plans, exhibits, and
photographs for any purpose unrelated to the City’s consideration of this application.
Furthermore, by submitting this application, I understand and agree that any business resulting from an
approval shall be maintained and operated in accordance with the requirements of the City of Palm Desert
Municipal Code and state law.
Name of Applicant Signature of Applicant
Title Date
A notary public or other officer completing this certificate verifies only the identity of the
individual who signed the document to which this certificate is attached and not the truthfulness
accuracy or validity of that document.
State of }
County of }
On before me, , a
Notary Public, personally appeared
who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are
subscribed to the within instrument and acknowledged to me that he/she/they executed the same
in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the
person(s), or the entity upon behalf of which the person(s) acted, executed the instrument.
I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing
paragraph is true and correct.
WITNESS my hand and official seal.
____________________________
Signature of Notary Public Place Notary Seal and/or Stamp Above