Medical Marijuana Dispensary, Cultivation And Infusion Separation Verification printable pdf download

"Planning with People for a Better Phoenix"

Application #____________

Medical Marijuana Dispensary, Cultivation

and Infusion Separation Verification

–PLEASE READ THE FOLLOWING CAREFULLY–

The intent of this form is to reserve a site for medical marijuana dispensaries, cultivation or infusion facilities within the

City of Phoenix. This form does not grant the use nor approve such location without meeting the requirements within the

Zoning Ordinance and Arizona Revised Statues Title 36 Chapter 28.1. This is a reservation of the site on a first-come first-

serve basis to verify compliance with the Zoning Ordinance.

The following criteria are required by City of Phoenix Zoning Ordinance and documentation must be submitted with this

separation verification:

Dispensaries:

1. Locations of all existing and/or pending medical marijuana dispensaries, cultivation and infusion facilities within

5,280 feet (1 mile) of this site

2. Location of all preschool, kindergarten, elementary, secondary or high school, public park, public community

center, dependent care facilities, homeless shelters, youth community centers within 1,320 feet of this site.

3. Location of all places of worship within 1,320 feet of this site.

4. Location of residentially zoned property within 500 feet of this site.

5. Maximum 2,000 square feet in size.

Cultivation and Infusion:

1. Locations of all existing and/or pending medical marijuana dispensaries, cultivation and infusion facilities within

5,280 feet (1 mile) of this site

2. Location of all preschool, kindergarten, elementary, secondary or high school, public park, public community

center, dependent care facilities, homeless shelters, youth community centers within 1,320 feet of this site.

3. Location of all places of worship within 1,320 feet of this site.

4. Location of residentially zoned property within 1,000 feet of this site.

–COMPLETE THE FOLLOWING INFORMATION–



Check One:

Medical Marijuana Cultivation Facility



Medical Marijuana Dispensary Facility



Medical Marijuana Infusion Facility

1. Property Address:

Suite:

Zip Code

2. Legal Description:

3. Tax Parcel Number:

4. Owner or Operators Name:

Address:

City, State & Zip Code:

Phone Number:

This and other forms can be found on our website:

Page 1 of 2

Revised 5/17/16

Planning & Development Department – Zoning Section – 200 W. Washington Street, 2nd Floor, Phoenix, Arizona 85003 – 602-262-7131 #6

00007

Medical Marijuana Dispensary, Cultivation And Infusion Separation Verification

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