Required fields are marked with asterisks (*)

Marijuana license renewal or modification

Every local business that sells marijuana must obtain a license through the City Clerk's Office and the Local Licensing Authority. Businesses are also required to renew their license annually.

The fees for a renewal or modification include:

Renewal of Local License - $1,965.00
Transfer of Ownership - $3,930.00
Modification of Premises - $1,965.00
Change in Location - $1,926.00
Change of Manager - $0.00
Change in Financial Interest - $0.00 - ownership being retained

The City Clerk's office will issue you an invoice when you submit this application.

Filing purpose

Renewal of Local License

Change of Manager

Transfer of Ownership

Change in Financial Interest

Modification of Premises

Change In Location

Other

Business type

Retail Marijuana Store

Medical Marijuana Store

Combined Use (Medical / Retail)

Other

Applicant / Company Name

Trade name / Doing Business As name

Marijuana license number

Business address

Mailing address

Business phone number

Email address

Name of on-site manager

Manager phone number

Manager e-mail address

If the applicant is a corporation, partnership, limited liability company, association or other type of entity, you must supply a list all officers, directors, partners or members. In addition, list all other persons or entities having any financial interest in the business.

Please upload a list of people or entities that have a financial interest.

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Allowed extensions pdf, doc, docx, xls, xlsx, jpg, jpeg, png

Legal possession of premises

Ownership

Lease

Other

Has the applicant (including anyone holding a financial interest) ever been denied a marijuana license in Colorado or any other state?

Yes

Has the applicant (including anyone holding a financial interest) ever had a marijuana license suspended or revoked in Colorado or any other state?

Yes

Has the applicant (including anyone holding a financial interest) ever had an interest in another entity that has had a license denied, suspended or revoked in Colorado or any other state?

Yes

Are you seeking a biennial (two-year) license term for your local license?

Yes

Affirmations

I declare, under penalty of perjury, the statements on this application, and all attachments to, are true, correct and complete to the best of my knowledge.

I understand and acknowledge that if any information contained herein or submitted as part of this application is found to be false or misleading it may result in this application being denied or any license granted pursuant to this application, suspended or revoked, in additional to a possible filing of applicable charges.

I acknowledge it is my responsibility to become familiar with and comply with the provision of Chapter 5.10 of the Louisville Municipal Code.

I understand that this submission will not be considered complete until the appropriate fees have been paid.

By checking this box, I am confirming my typed name below is my legal name and serves as my electronic signature. I agree that my electronic signature is the legal equivalent of my manual signature on this submission.

Type your full name to sign this application

Title

An invoice for any applicable fees will be issued by the City Clerk's Office. Please provide an email address for the invoice.