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2. Updated Fees for 2024 - Choose Type of Local License Renewal

   1. Retail Store $500.00
   2. Retail Products Manufacturer $500.00
   3. Retail Cultivation $500.00
   4. Medical Center $250.00
   5. Medical Products Manufacturer $250.00
   6. Medical Center Cultivation $250.00
4. Colorado State Application Submitted?

   1. Yes
   2. No
5. Town of Eagle Business License Current?

   1. Yes
   2. No
7. Business and Trade Name *
9. Physical and Mailing Address*
11. Owner/Applicant Full Name
12. Owner/Applicant Date of Birth
    Owner/Applicant Date of Birth
14. Owner Email Address
15. Owner Phone Number
16. Type of Ownership
    -- Select One --CorporationLimited Liability CompanyPartnershipSole ProprietorshipOther
18. Manager Name
19. Manager Home Mailing Address
20. Manager Date of Birth
    Manager Date of Birth
22. Manager Contact Phone
23. Manager Email Address
25. Property Owner Name and Mailing Address

    If premises is leased, written proof of lease is required annually and must be signed by the property owner. 

26. Proof of lease (attachment)
28. State License Number
29. License Expiration Date
30. State Sales Tax License Number
31. FEIN Number
35. Medical and Retail Marijuana License Indemnification and Affidavit of Acknowledgement

    As an applicant for a Medical or Retail Marijuana License, I hereby acknowledge and agree to the following:

37. Applicant has received a special use permit to operate the proposed Regulated Marijuana Business in accordance with the Town’s Land Use and Development Code contained in Title 4 of the Eagle Municipal Code and agrees to abide by and conform to all of the conditions listed therein.

    1. Yes
    2. No
39. Applicant has obtained and examined a copy of the pertinent provisions of the Town of Eagle's Municipal Code pertaining to zoning and business licensing, and agrees to abide by and conform to all of the conditions of the Medical or Retail Marijuana License requirements and all provisions of the Town of Eagle's Municipal Code.

    1. Yes
    2. No
41. Applicant understands and acknowledges that the approval of the Medical or Retail Marijuana License, if granted, shall in no way License any activity contrary to the Town of Eagle's Municipal Code or any activity which is in violation of any applicable laws.

    1. Yes
    2. No
43. Applicant understands that the Town accepts no legal liability in connection with the approval and subsequent operation of the retail marijuana business.

    1. Yes
    2. No
45. Applicant understands that if a medical or retail marijuana License is issued, it is valid for a period of one (1) year from the date of issuance. I further understand it is the Licensetee’s responsibility to submit an application for the renewal of the License no later than forty-five (45) days prior to the date of expiration if such renewal is desired.

    1. Yes
    2. No
47. Applicant understands that by accepting a License issued pursuant to the Town of Eagle’s Municipal Code, the Licensee agrees to release the Town, its officers, elected officials, employees, attorneys, and agents from any liability for injuries, damages, or liabilities of any kind that result from any arrest or prosecution of Licensee’s owners, operators, employees, clients or customers for a violation of state or federal laws, rules or regulations.

    1. Yes
    2. No
49. Additional Items that may be requested and provided if any changes have been made:

    An operating plan for the proposed medical/retail marijuana business including the following information:

    A description of the products and services to be provided by the Regulated/retail marijuana business, including an indication of whether or not the facility proposes to engage in the retail sale of medical or retail marijuana-infused products for human consumption.

    A floor plan showing all interior dimensions of the licensed premises and the layout of the medical and/or retail marijuana business. Such floor plan shall also show the principal uses of the floor area depicted therein, including a depiction of where any services other than the dispensing of medical or retail marijuana are proposed to occur on the licensed premises. If the building or proposed licensed premises is not yet in existence, the applicant shall file a plot plan and a detailed sketch for the interior and submit an architect's drawing of any building to be constructed.

    A security plan containing all information required by the State Licensing Authority's regulations.

    A lighting plan, including security lighting, for the licensed premises and adjacent grounds.

    Any information and/or documentation not included in the foregoing subsections that is or will be required in an application to be filed with the State Licensing Authority for the State license that may be issued in accordance with the provisions of the Colorado Regulated Marijuana Business Code. 

53. ACKNOWLEDGMENT AND CONSENT: By signing below I am giving my acknowledgment and consent that the Town will conduct a background investigation, including a criminal history check, and that the Town will be entitled to full and complete disclosure of all financial records of the retail or medical marijuana establishment, including records of deposit, withdrawals, balances, and loans and verify the truthfulness of the information provided on this form.
55. By typing your name, you consent to the above:
57. PAYMENT CASH OR CHECK ONLY

    Payment can be made by mailing a check to Town of Eagle PO Box 609 Eagle CO 81631 or you are free to stop in to 200 Broadway and pay with cash or check. Any questions, please contact the Town Clerk at 970-328-6354 or clerk@townofeagle.org.

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59. 1. Receive an email copy of this form.
60. Email address

    This field is not part of the form submission.

61. Submit Submit and Print

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