Medical Marijuana Establishment Conditional Use Permit Application Project Information Project Name Project Location Assessor’s Parcel Number(s) Existing Zoning

Gross Acres

Please explain the intent of this request and type of establishment

Applicant Signature

Date

Applicant Information Property Owner(s) Mailing Address Phone No

Email

Fax No

Email

Fax No

Applicant (if different than Owner) Mailing Address Phone No

Contact Person/Representative (if different than Owner) Mailing Address Phone No

Email

Fax No

Office Use Only Case No

Application Fee $

Date Received

Noticing Fee $

Received By

Planner

CUP-1

Planning and Environmental Resources 10 E. Mesquite Blvd., Mesquite, NV 89027 Phone (702) 346-2835, FAX (702) 346-5382, www.mesquitenv.gov

08/14

Checklist Please use the following list to prepare your complete application. If any information is missing, inaccurate or incomplete, the application will be deemed invalid and will not be accepted for processing.

 Application fee of $700 is due upon submittal.  Noticing Fees: Please contact us to calculate your fee. $10 per notice with a required minimum of 30 notices. Any notice above the quantity of 300 is $5 each. The fee amount and number of public notices is determined by the type of project and a specified distance from the project.

 One (1) original signed application, indicating the type of establishment i.e. Cultivation Facility, Dispensary, Independent Testing Laboratory, and/or Production Facility.  One (1) original, current and fully signed Owner Affidavit(s) plus one (1) copy .  Property owner’s letter of authorization for a medical marijuana related business.  A copy of the (draft) business operating procedures in accordance with the regulations, which addresses security, refuse plan, description of products to be provided, name and location of the off-site medical marijuana cultivation facility providing medical marijuana products, name and location of testing laboratory, and general operation of the facility,  Name and physical address of any other marijuana establishment within Clark County in which any owner, officer, manager, or director of the applicant has an ownership interest in, or contractual relationship or otherwise associated with, other medical marijuana establishments.  A description of all toxic, flammable or other materials regulated by a federal, state or local government with authority over the business that will be used or kept at the medical marijuana establishment, the location of such materials, how such materials will be stored, and how such materials will be used.  A plan that complies with existing Clark County health district regulations governing air quality for the medical marijuana establishment that prevents or controls any dust, fumes, vapors, or odor of marijuana off the premises of the establishment. CUP-2

Planning and Environmental Resources 10 E. Mesquite Blvd., Mesquite, NV 89027 Phone (702) 346-2835, FAX (702) 346-5382, www.mesquitenv.gov

08/14

 One (1) original legal description of the property plus one (1) copy. (A metes and bounds description is required if the property is not platted.)  Two (2) 24” x 36” site plan folded to 9” x 12” size and One (1) original 8 ½” x 11” site plan plus one (1) copy. (please refer to Mesquite Municipal Code (MMC) Section 9-5-3C and 9-156:).  A scaled floor plan (24” x 36” and 9” x 12” size) with labeled rooms, dimensioned, and ingress/egress.  Two (2) 8 ½” x 11” color renderings. One (1) 24” x 36” color rendering. One (1) color board, material(s) samples and signage (please refer to MMC 9-15-6:).  One (1) original Service Availability letter from each public utility plus one (1) copy: -City of Mesquite Sanitation Division. -Overton Power District No. 5. -Reliance Connects Telephone/Cable Company. -Orange Broadband. -Virgin Valley Disposal. -Virgin Valley Water District.  A digital copy of the submittal are required in the following formats: -All site plans must be in AutoCAD Version 14 or higher, DWG format. -All architectural renderings and building elevations must be in TIF, JPEG or PDF format. -All other documents can be submitted in TIF, JPEG, PDF or DOC format.

 Traffic Impact Analysis: Required if project will generate more than five hundred (100) vehicle trips per peak hour based on Institute of Transportation Engineer trip generation rates (Please refer to MMC Section 9-9-6C).

CUP-2

Planning and Environmental Resources 10 E. Mesquite Blvd., Mesquite, NV 89027 Phone (702) 346-2835, FAX (702) 346-5382, www.mesquitenv.gov

08/14