(Sample) Marijuana Sales Permit Process
May 02, 2017
submission
#1
Basic Business Information
Business information
| Business name | Sample Business |
| Primary address | 444 Flower Street, Los Angeles |
| State registration number | 59845349 |
| Local business registration number | 34534 |
| Type of marijuana sales proposed | Sales and on-site consumption |
Personal information
Business owner information
| Owner Name 1 | --- |
| Owner State ID | Sample_Form_citygrows.pdf |
| Owner State ID number | --- |
| Home address | --- |
| Months living at current address? | --- |
| Date of Birth (must be over 21) | --- |
| Any history of criminal convictions | --- |
Site visit report
Site visit report
| Date of site visit | 2017-04-10 |
| Completed by | Sam Doe |
| Items for correction | n/a |
| Additional notes | n/a |
Permit issued
Permit issued
| Permit number | 38383 |
| Date issued | 2017-05-02 |