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Page 1 of 2 Thomas B. Quaw Square ▪ 91 E. Central ▪ Belgrade, MT 59714 ▪ Phone: (406) 388-3760 ▪ Email: [EMAIL REDACTED] April 4, 2022 Dear Applicant: Marijuana businesses within the City of Belgrade Zoning Jurisdiction is regulated pursuant to state law, City of Belgrade Ordinance No. 2022-3 and the Belgrade City Code. All applicable building and fire codes/inspections also apply to these businesses. Submittal requirements for marijuana business licenses include a completed application form, a City of Belgrade Business License Application (the application fee for this item will be waived), copies of all related state licenses including the date of expiration, and verification that the location of the marijuana business complies with state and local regulations. The verification statement that the location of the marijuana business complies with state and local regulations must include at a minimum the following information: • The proposed location is not located within any residential zoning district or a PLI District. • The proposed location is not located within 500 feet of or on the same street as a school, church, synagogue, or other place of worship. • The proposed location is not located within 500 feet of lots used for public or quasi- public buildings or churches as defined in §10-3U-2 of the City Code of Belgrade Montana. • The proposed location is not located within 500 feet from any residence, in any direction, located in R-1, R-2, R-2D, R-2M, R-3, and R-4 Districts. • The proposed location is not located within 500 feet, in any direction, of Lewis and Clark Park. City staff will do a cursory review to ensure compliance, but the applicant is responsible for verification that the location complies with state law. Please note that, in some cases, additional information may be required before a license may be issued. All City of Belgrade Marijuana Business Licenses must be renewed annually and are non-transferable. Pursuant to City of Belgrade Ordinance No. 2022-3, the cost of an annual marijuana business license is $100.00. City of Belgrade Planning and Building Department ---PAGE BREAK--- Page 2 of 2 Thomas B. Quaw Square ▪ 91 E. Central ▪ Belgrade, MT 59714 ▪ Phone: (406) 388-3760 ▪ Email: [EMAIL REDACTED] CITY OF BELGRADE MARIJUANA BUSINESS LICENSE APPLICATION Business License (OFFICE USE ONLY) $100.00 Fee to the City of Belgrade Business Name Physical Address Mailing Address Business Email Type of Marijuana Business (Check All That Apply): Dispensary Manufacturer Transporter Cultivator Tester Business Owner Full Legal Email Co-Owner Manager (Check One) Full Legal Location Verification Statement: The location of this marijuana business is in compliance with all separation requirements of Sec. 16-12-207, MCA The proposed location is not located within any residential zoning district or a PLI District. The proposed location is not located within 500 feet of or on the same street as a school, church, synagogue, or other place of worship. The proposed location is not located within 500 feet of lots used for public or quasi-public buildings or churches as defined in §10-3U-2 of the City Code of Belgrade Montana. The proposed location is not located within 500 feet from any residence, in any direction, located in R-1, R-2, R-2D, R-2M, R-3, and R-4 Districts. The proposed location is not located within 500 feet, in any direction, of Lewis and Clark Park. In addition to this form, please submit this application with the following materials: A City of Belgrade Business License Application (the application fee for this item will be waived), a Copy of all applicable state licenses issued by Dept. of Revenue for activities occurring at location listed above, including marijuana worker permits for individuals listed on this application, and written permission of the property owner (if different than the business owner) to conduct a marijuana business on the premises. This application is made subject to the terms of the Belgrade City Code. I understand that this license is NOT TRANSFERABLE and MUST BE RENEWED ANNUALLY. Further, I declare under penalty of Perjury or False Swearing that the information I have supplied is correct to the best of my knowledge. OFFICE USE ONLY: Zoning Final Approval Date Comments