(A) An application for a medical marijuana facility certificate of occupancy shall be made in writing to the Township Zoning Administrator, who is authorized to create application forms and to receive and process applications and to thereafter grant, deny, suspend, or revoke said certificate of occupancy as set forth in this subchapter. Applications shall be on forms supplied by, and to be filed with, the Township Zoning Administrator. Such application shall be signed and dated by the applicant.
(B) The application shall contain the following information, plus any other information deemed necessary by the Township Zoning Administrator:
(1) The name and any alias used, address, and telephone number of the applicant;
(2) The location of the medical marijuana facility and a brief description of the amount of marijuana to be distributed or number of plants to be grown on the premises, if any;
(3) Caregiver must disclose only the date of birth of the qualifying patient, the date of issuance and expiration date of the medical marijuana registry identification card, and the random identification number assigned to each qualified patient;
(4) The applicant’s criminal record, if any;
(5) An authorization for the Township Zoning Administrator and/or the township’s Police Department to carry out a background investigation on the applicant;
(6) If the applicant is not the owner of the proposed location of the medical marijuana facility, a notarized statement from the owner of the property authorizing submission of the application;
(7) An acknowledgment by the applicant that he or she, as well as his or her qualifying patients, may be subject to prosecution under federal laws relating to the possession and distribution of controlled substances, and that the township accepts no legal liability in connection with the approval and operation of the medical marijuana caregiver grow facility; and
(8) A statement that the information provided is true and accurate and that, if a certificate of occupancy is granted, the applicant will abide by all applicable ordinances and statutes.
(C) The names and other identifying information of any qualifying patient or registered primary caregiver gathered for the purposes of this subchapter shall be exempt from disclosure pursuant to the state’s Medical Marijuana Act.
(Ord. 5, passed 1-18-1973)