{[ADDR]}
{[CITY]}, {[STATE]} {[ZIP]}
(732) 530-2764
{[AWEBSITE]}
Apt/Unit #
Block
If the Zoning Review determined that the proposed cannabis operation is not a permitted use in the location above, has the Applicant secured approval for the cannabis operation from the Planning Board or Zoning Board of Adjustment?
What location are you planning on opening your business? Begin by typing the property number and then select from the populated dropdown.
Lot
Zone
{[PNAME]}
Property Details
Use Permit Reference #
Apply for a Use Permit
Application Type
Address
Date Approved by Zoning Officer?
Use Permit Status?
NOTE: The proposed location shall be no closer than 500 feet from the primary entrance of the nearest public or private K-12 school unless within the boundaries of the downtown Special Improvement District. Click here for a list of permitted locations or you may consult the community map.
Use Permit
If the applicant hasn't applied, please apply for a Use Permit below before submission of this application.
  • Contacts
  • Business Structure
  • License Details
  • Evaluation Criteria
  • Additional Information
  • Attachments
  • Certification
ZIP
Address
Trade name, alt. name or “doing business as” name of cannabis establishment
Legal name of business registered to do business in the State of New Jersey
Email
NJ Business Registration Certificate Number
Business Owner's Name
Phone #
City
Primary Contact
State
ZIP
Name
Title
City
Phone
Applicant Information
The primary contact is?
City, State, ZIP
Business Owner's Address (no PO Boxes)
Email
Mailing Address
Email
Name
Federal Tax Identification Number
State
Website (if any)
Phone #
State Tax Identification Number
Property Owner
If yes, provide documentation.
If yes, provide documentation or certification that Applicant meets the criteria.
Does the Applicant operate an Alternative Treatment Center (ATC) in New Jersey?
If other, describe:
Monday

Is the Applicant a certified Diversely Owned Business, pursuant to the criteria in N.J.A.C. 17:30-6.4?

  1. A minority business pursuant to N.J.S.A. 52:27H-21.18 et seq.;
  2. A women’s business pursuant to N.J.S.A. 52:27H-21.18 et seq.;
  3. A disabled-veterans’ business, as defined in N.J.S.A. 52:32-31.2; or
  4. Any combination of one through three above
Total % Owned (must equal 100%)
Applicant Business Structure
Has any person above had any cannabis license or permit revoked for a violation affecting public safety in New Jersey or a subdivision in the state within the preceding five (5) years?

Is the Applicant a Microbusiness under P.L.2021, c.16 (C.24:6I-31 et al.)?

  1. employs no more than 10 employees;
  2. operates a cannabis establishment occupying an area of no more than 2,500 square feet, and in the case of a cannabis cultivator, grow cannabis on an area no more than 2,500 square feet measured on a horizontal plane and grow above that plane not higher than 24 feet;
  3. possesses no more than 1,000 cannabis plants each month, except that a cannabis distributor's possession of cannabis plants for transportation shall not be subject to this limit;
  4. acquires each month, in the case of a cannabis manufacturer, no more than 1,000 pounds of usable cannabis;
  5. acquires for resale each month, in the case of a cannabis wholesaler, no more than 1,000 pounds of usable cannabis, or the equivalent amount in any form of manufactured cannabis product or cannabis resin, or any combination thereof; and
  6. acquires for retail sale each month, in the case of a cannabis retailer, no more than 1,000 pounds of usable cannabis, or the equivalent amount in any form of manufactured cannabis product or cannabis resin, or any combination thereof.
Thursday
Name of ATC
Friday
Business Structure
Tuesday
Sunday
If yes, provide further information:
Address of ATC

Is the Applicant a Social Equity Business under N.J.A.C.17:30-6.6, meeting one of the following criteria?

  1. More than 50 percent of the ownership interest of the license applicant or license holder is held by one or more persons that demonstrate one of the following criteria:
    1. At the time the initial application is submitted, have lived in an economically disadvantaged area for five of the 10 preceding years; and
    2. Are, at the time the initial application is submitted and based on the preceding year's income, a member of a household that has a total household income that is 80 percent or less of the average median household income in the State, as determined annually by the U.S. Census Bureau; or
  2. More than 50 percent of the ownership interest of the license applicant or license holder is held by one or more persons who are eligible to be pronounced rehabilitated in accordance with N.J.A.C. 17:30-7.12(e), if necessary, and have been adjudicated delinquent for, or convicted of, whether expunged or not, in this State, another state, or the Federal government:
    1. At least two marijuana- or hashish-related disorderly persons offenses; or
    2. At least one marijuana- or hashish-related indictable offense.
If yes, provide documentation.
Saturday
Wednesday
Proposed Hours of Operation
Provide a complete list of every person with interest staked in the proposed cannabis business including the full name, title within the entity, date owner acquired interest in entity, the percentage of ownership interest, and financial interest in any other cannabis business.
Does any owner meet the New Jersey Administrative Code and/or regulations as a social equity, minority, woman, disabled veteran or microbusiness owner?
License Details
Type of Municipal Cannabis License Requested
Will there be a consumption area?
(Retailer Only)
Has the Applicant secured a New Jersey cannabis license as of the date of this application?
If no, what is the status of the Applicant’s state cannabis license application?
If Cannabis Consumption Area, provide a description of consumption area operations
Describe any and all ties to the South Orange community.
Describe proposal to provide community benefits. (Response not to exceed 3,000 words)
Areas to consider:
*Financial and in-kind contributions to South Orange's drug and alcohol prevention programs, social work and mental health intervention initiatives, and other health related activities
*Financial and in-kind contributions to community, civic, cultural and business associations/organizations (provide examples)
*Education programs for various populations on topics such as securing a medical cannabis card, expunging cannabis criminal records, and engaging in an employment transition through a re-entry program
Describe qualifications and experience of the Applicants/owners in operating in highly regulated industries in New Jersey or another state, including cannabis, healthcare, pharmaceutical manufacturing, and retail pharmacies. (Response not to exceed 2,500 words)
Describe experience as a responsible employer or a commitment to being a responsible employer. Examples are providing employee health care insurance, providing paid family leave and/or paying a $15 minimum wage
Describe plans for the storage of products, physical security, video surveillance, security personnel and visitor management. (Response not to exceed 2,500 words)
Areas to consider:
* inventory control
* delivery and shipping procedures
* on-site security guards and their responsibilities
* general description of security cameras and alarms
* estimated number of customers/visitors per day
* customer/visitor check in procedures and access to sales area
* off-street parking arrangements for employees and customers/visitors
* procedures and training for all fire and medical emergencies and hazardous situations
* sample of signage that it is illegal to sell to anyone 21 years and under and that the store will check ID upon purchase
* procedure for handling a customer exhibiting alcohol and/or substance abuse
Provide a written commitment and describe the recruitment and hiring procedures to be used to recruit South Orange residents and Seton Hall Students for employment. (Response not to exceed 1,000 words)
Describe environmental impact and sustainability plan. (Response not to exceed 1,000 words)
Areas to consider:
* management of solid waste and recyclable materials
* incorporation of environmentally sustainable business practices such as solar installations, energy efficient products and operations, electric or hybrid vehicles
* exhaust and ventilation systems to prevent odors from operations to be detected beyond the licensed premises
* use, storage and disposal of any gases or chemicals used in operations, if applicable
The following are to be answered in paragraph form. Responses are to be word limited as indicated below.
Evaluation Criteria
Describe a demonstrated commitment to diversity in its ownership composition and hiring practices. (Response not to exceed 1,500 words)
*Provide evidence of ownership composition or hiring practices that have increased or will increase diversity with regards to race, culture, sexual orientation and gender identity.
Describe the financial capability of the Applicant to open and operate a cannabis establishment. Please identify the sources of funds to do so and provide any financial source agreements.
Financial Information
Identify a Community Relations Liaison, who shall receive all complaints regarding the cannabis business.
Do you commit to posting the Liaison’s name and contact information in the lobby of the cannabis establishment and providing such information to the South Orange Clerk's Office, Building Department, Police Department and Fire Department.
Name
Neighborhood Compatibility
Describe how the Applicant will make good faith efforts to promptly resolve all complaints, including those related to noise, light, odor, litter, vehicle traffic and pedestrian traffic.
Provide name, address, email address, phone number and age of each person/entity with a non-ownership financial interest in the cannabis establishment, which shall include an investment, loan or any other type of equity.
Phone Number
Email

Affirmative Action, Anti-Discrimination and Fair Employment

  1. Provide an affidavit and documentary proof of compliance with all state and local laws regarding affirmative action, anti-discrimination and fair employment practices.
  1. Provide a certified statement under oath there will be no discrimination based on race, color, religion (creed), gender, gender expression, gender identity, age, national origin (ancestry), disability, marital status, sexual orientation or military status in any of the Applicant’s activities or operations.
Microbusiness Documentation
If any of the above required documents cannot be provided, please state why. Applications may be held up or rejected if deemed incomplete.
Please Confirm the Following Are Attached
New Jersey Cannabis License
Social Equity Documentation
Please confirm you have read the above and provided the requested affidavits and documents.
New Jersey Business Certificate
Use Permit
Planning or Zoning Board Approval
Diversely Owned Business Documentation
Attachments
Type Full Name :
Sign With Hand
Method of Payment
Applicant Signature
Certification
Fee Due
The undersigned declares under penalty of perjury that I have read and understand the provisions of South Orange Ordinances 2022-01, 2022-02 and 2022-03 and that the operation of this cannabis establishment must adhere to all the requirements of South Orange's Municipal Code and all other applicable state and local laws and all regulations promulgated thereunder.

I understand that I am the responsible party for any violation(s) of the cannabis establishment that may arise.

I understand and acknowledge that a license issued based on false or misleading statements provided in this application will be deemed invalid and subject to revocation.

I understand that the South Orange Village may approve or deny an application for a municipal cannabis license at its sole discretion, consistent with all governing State Law, based on an evaluation of the benefits to South Orange Village.

I declare under penalty of perjury under the laws of the State of New Jersey that the foregoing statements are true and correct.
Class 3 Wholesaler $7,000
Class 4 Distributor $7,000
Class 5 Retailer $7,000
Class 6 Delivery $7,000
Microbusiness $3,500
Fee Schedule
*Applications not receiving a municipal endorsement are eligible for a refund.
All others are nonrefundable.
  1. This license application is subject to the provisions and exceptions set forth in the New Jersey Open Public Records Act, N.J.S.A. 47:1A-1 et. seq. and as such the application is considered public information.
  2. A license application shall be deemed incomplete, and shall not be processed, until all documents and application fees are submitted. Once South Orange Village has determined the application is complete, it will notify the Applicant.
  3. South Orange Village may approve or deny an application for a municipal cannabis license at its sole discretion, consistent with all governing State Law, based on an evaluation of the benefits to South Orange Village.