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2. Instructions & Form Below
   Ordinances Section 421-64.1 Cannabis-oriented uses

   PLEASE NOTE THAT THE CITY IS NOT ACCEPTING CLASS 5 RETAIL CANNABIS APPLICATIONS AT THIS TIME.

   Applicants shall refer to Rahway Municipal Ordinances Section 421-64.1 Cannabis-oriented uses regarding the municipal requirements for Cannabis businesses and facilities.

   Pursuant to O-14-22, a non-refundable $1,000 application fee, payable to "City of Rahway" must be submitted to the City Clerk following electronic submission of this application.

   Your application will not be processed until the fee is received by the City Clerk.

   Please download and sign the following documents, and attach them to your application:

   1. Affidavit Application

   Please have the following ready to be uploaded:

   1. (For Micro-business): Signed letter from business owner who owns space to be occupied
   2. Additional information to answer Disclosure statements
   3. Documents requested under Financial Capability
   4. Documents  requested in Proposal Requirements
   5. If the entire building or floor will not be licensed, a detailed sketch to delineate the licensed area
4. Affidavit Application*
6. Please select the Class type of the proposed cannabis facility. Check all that apply:*

   Full Class Descriptions:

   1. Cannabis Cultivator license, for facilities involved in growing and cultivating cannabis.
   2. Cannabis Manufacturer license, for facilities involved in the manufacturing, preparation, and packaging of cannabis items.
   3. Cannabis Wholesaler license, for facilities involved in obtaining and selling cannabis items for later resale by other licensees.
   4. Cannabis Distributor license, for businesses involved in transporting cannabis plants in bulk from one licensed cultivator to another licensed cultivator, or cannabis items in bulk from any type of licensed cannabis business to another.
   5. Cannabis Retailer license for locations at which cannabis items and related supplies are sold to consumers.
   6. Cannabis Delivery license, for businesses providing courier services for consumer purchases that are fulfilled by a licensed cannabis retailer in order to make deliveries of the purchased items to a consumer, and which service would include the ability of a consumer to make a purchase directly through the cannabis delivery service which would be presented by the delivery service for fulfillment by a retailer and then delivered to a consumer.

   1. Class 1 Cannabis Cultivator license
   2. Class 2 Cannabis Manufacturer license
   3. Class 3 Cannabis Wholesaler license

   1. Class 4 Cannabis Distributor license
   2. Class 5 Cannabis Retailer
   3. Class 6 Cannabis Delivery
8. Entity Preparing Application*

   1. Property Owner
   2. Cannabis Business Owner

   1. Attorney for Property or Business Owner
   2. Other
10. Entity Name If Other Checked*
12. Property Information (Site where license will be used):
14. Block(s)*
15. Lot(s)*
17. Street Address*
19. Property Area
20. Zone District
22. Are cannabis uses currently permitted in this Zone?*

    1. Yes
    2. No
23. Is the property adjacent to a residential use or Zone?*

    1. Yes
    2. No
24. Is the property within 200 feet of an entrance to a school or church?*

    1. Yes
    2. No
26. Property Owner Name*
27. Telephone Number*
28. Fax Number
30. E-Mail Address
32. Address Of Property Owner*
34. Are there any environmental encumbrances on the site?*

    Does the property fall under the jurisdiction of the DEP, EPA, or other similar regulatory agency?

    1. Yes

    1. No
36. If yes, provide narrative below. Be specific.*
40. Business Information
42. Is Property Owner Also The Applicant?*

    1. Yes

    1. No
44. Applicant Name(s)*

    Please list applicant(s) name(s) as it will appear on the license and the licensed applicant(s) legal names under which they are registered to do business

46. Address(es) of Applicant(s)*
48. Best Contact Telephone Number*
49. Best E-mail Contact*
50. Best Fax Number
52. New Jersey Sales Tax Certificate Authority No.: *
53. Will the license be used at an operating place of business immediately upon issuance?

    1. Yes

    1. No
55. If no, provide the anticipated date of license activation: *
    If no, provide the anticipated date of license activation:
57. Is the proposed cannabis facility a “microbusiness” as defined by State regulations? *

    1. Yes

    1. No
58. If yes, will the microbusiness be occupying space within an existing cannabis facility? *

    1. Yes

    1. No
60. Signed Letter From Business Owner Who Owns Space To Be Occupied*
62. If yes, please provide the following information - Name of business whose space the microbusiness will be occupying: *
64. Check the box that represents the certifications currently held by your business and type of business organization*

    1. Women Business Enterprise (WBE)
    2. Minority Business Enterprise (MBE)
    3. Veteran-Owned Business (VBE)
    4. Sole Proprietorship
    5. Non-Profit Corporation
    6. For-Profit Corporation (any-type)

    1. Limited Liability Company (LLC)
    2. Partnership
    3. Limited Partnership
    4. Limited Liability Partnership
    5. Other
66. Other:*
68. Stakeholder Question*

    No one stakeholder in the corporation owns 10 percent or more of its stock, of any class, or no individual partner in the partnership owns a 10 percent or greater interest therein, or no member in the limited liability company owns a 10 percent or greater interest therein, as the case may be.

    1. Yes, no stakeholder owns 10 percent or more

    1. No, there are stakeholders who own 10 percent or more
70. Stakeholder Information*

    The List above contains the names and addresses of all stockholders in the corporation who own 10 percent or more of its stock, of any class, or of all individual partners in the partnership who own a 10 percent or greater interest therein, or of all members in the limited liability company who own a 10 percent or greater interest therein, as the case may be.

74. Disclosures
76. Is the applicant or any other person mentioned in this application related to an elected official, board member or employee within the City of Rahway?*

    1. Yes

    1. No
78. If yes, please provide the following information:*
    1. Name: 
    2. Title of position held:
    3. Name of Authority, Board, or Department:
    4. Relationship to applicant: 
80. Is the applicant or any other person mentioned in this application a police officer or hold any position entrusted with the enforcement of any laws concerning cannabis in any manner whatsoever? *

    1. Yes

    1. No
82. If yes, please provide the following information:*
    1. Name:
    2. Title of position held:
    3. Name of employing authority:
84. Does the applicant or any other person mentioned in this application, or any person having a beneficial interest in the licensed business, hold office in the unit of government issuing the license? *

    1. Yes

    1. No
86. If yes, please provide the following information:*
    1. Name: 
    2. Title of position held:
    3. Unit of Government: 
88. Has the applicant ever been denied a cannabis license in the State of New Jersey or any other jurisdiction? *

    1. Yes

    1. No
90. If yes, please provide the following information:*
    1. Type of license or permit denied:
    2. Unit of government which denied license or permit: 
    3. Date of denial (approximate if not known: 
    4. Reason for denial: 
92. Has any corporation, partnership or individual mentioned in this application, other than the applicant, been denied a cannabis license or permit in the State of New Jersey or any other jurisdiction?*

    1. Yes

    1. No
94. If yes, please provide the following information:*
    1. Name/Entity:
    2. Type of license or permit denied:
    3. Unit of government which denied license or permit:
    4. Date of denial (approximate if not known)
    5. Reason for denial: 
96. Has the applicant, or any other person, corporation or entity mentioned in this license application, or anyone with a beneficial interest in it, had an interest in a cannabis license which was surrendered, suspended, or had a penalty imposed in lieu of suspension, not renewed, revoked or cancelled within 10 years prior to the date of this application? *

    1. Yes

    1. No
98. If yes, please provide the following information:*
    1. Name:
    2. Date of action: 
    3. Issuing authority of penalty: 
    4. Penalty consisted of:
100. Has the applicant or any other person or corporation mentioned in this license application, or anyone with a beneficial interest in the business under license or to be licenses, ever been convicted of a criminal offense subject to the parameters set forth in N.J.A.C. 17:30-7.12. The submission to the Cannabis Regulatory Commission would be sufficient. *

     1. Yes

     1. No
102. If yes, please provide the following information:*
     1. Name: 
     2. Date of birth: 
     3. Conviction date: 
     4. Description of offense (specific charge): 
     5. Disposition (fine, penalty, etc.):
     6. Nature of interest in entity to be licensed:
104. Does the applicant, a member of the applicant’s immediate family (spouse, children, parents, in-laws, or siblings) or any person with a beneficial interest in the subject license of this application, have any interest in any other New Jersey cannabis license?*

     1. Yes

     1. No
106. If yes, please provide the information below *
     1. License Number: 
     2. Name: 
     3. Relationship to applicant: 
108. Is the applicant proposing to transfer the license to another person/entity? *

     1. Yes

     1. No
110. If yes, please complete the following information:*
     1. Name of person/entity license is to be transferred to: 
     2. Anticipated date of transfer: 
112. Additional Information

     If you said "Yes" to any items above and need to provide additional detail, please upload information here. 

116. Background Check
118. Have you ever been known or identified by a name other than the name indicated on this application? *

     1. Yes

     1. No
120. If yes, please list the names you were previously known or identified as:*
122. Electronic Signature Agreement*

     Applicant agrees that:

     (1) Applicant is of full age,

     (2) Applicant authorizes and consents to a background check Rahway Police Department

     (3) By checking the "I agree" box below, Applicant agrees and acknowledges that A) your application will not be signed in the sense of a traditional paper document, B) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and C) you may still be required to provide a traditional signature at a later date.

     1. I agree.
124. Electronic Signature
128. Project Information
130. Number of buildings to be included under license and total building area (in square feet)*
132. Is the entire building to be licensed?*

     1. Yes

     1. No
133. Ground floor footprint area (in square feet)*
135. If no, specify which floors of the building are to be licensed; if part of any floor, applicant must attach detailed explanations with sketches to delineate*
137. Are any grounds adjacent to the building to be included as part of the licensed premises?*

     1. Yes
     2. No
138. Will there be any unlicensed area located between buildings under this license, or between licensed adjacent grounds?*

     1. Yes
     2. No
139. Does the applicant own the building? *

     1. Yes
     2. No
141. If yes, provide the following mortgage information if applicable:*
     1. Mortgagee name:
     2. Mortgagee address:

     If you do not have a mortgage, please type "N/A."

142. If no, provide the following landlord information if applicable:*
     1. Landlord name:
     2. Landlord address:
144. Total number of parking spaces (if project will only be permitted to utilize a portion of existing parking, please also indicate the number of spaces to be used by licensed facility): *
145. Total number of loading spaces (if project will only be permitted to utilize a portion of existing parking, please also indicate the number of spaces to be used by licensed facility): *
149. Financial Capability*

     Please upload the following information including (but not limited to):

     1. Operating Proforma including but not limited to, construction and fit out costs, a forecast of operational expenses including but not limited to salaries, equipment, security, interest and loan payments, taxes, income, advertising, and facility maintenance. 
     2. A summary of the amount and source of investment capital (debt and equity) anticipated to be available for the successful development of the proposed project.
     3. Three (3) financial references, including a banking reference, noting the names, addresses and telephone numbers.
     4. Financial statements (audited preferred) for the general partner or controlling entity of the development team for the last three (3) years.
     5. Disclose any information that may be deemed unfavorably under generally accepted accounting practices and, in addition thereto, any history of bankruptcy, insolvency, receivership, or similar declaration or status determination with respect to individuals or entities associated with the applicant or any entity or affiliate therefore or individuals, or entities that are principals of said applicant.
     6. Provide specific information on how applicant has financed other cannabis facilities. Indicate the source and amount of debt and equity funds applicant’s firm has arranged in the past.

     If endorsed by the Municipal Council of the City of Rahway, all cannabis facilities will be required to submit audited financial statements annually to support the estimated quarterly revenue payments each year.

153. Proposal Requirements*

     As a supplement to this application provide a proposal detailing the proposed cannabis business including but not limited to the following details.   Proposals must be submitted using the section numbers listed below.  Inconsistent formatting will be considered when the application is reviewed.

     Section 1 - Facility Information: Existing and proposed property/site conditions – describe the land (impervious/pervious) and structures currently occupying the site and any changes proposed to create the cannabis business/facility. Clarify whether there is more than one building on the property or if more than one building will be use or whether the business will occupy a part of a larger facility and the use of any other portion of the building.  Provide the intended building size (total square footage) as well as building height. Include provisions for parking and information related to air quality systems that will be used. Provide pictures of the proposed building/facility exterior and interior if available. The applicant shall describe how they will make good faith efforts to promptly resolve all complaints, including those related to noise, light, odor, litter, vehicle traffic and pedestrian traffic. 

     Section 2 - Surrounding properties and conditions: Describe the properties and roadways surrounding the proposed facility site; indicate the type of uses, building heights.  Are there any schools, playgrounds, parks, churches, or senior occupied multiple dwelling buildings within 200-feet of the proposed facility.

     Section 3 - Business Experience:   Detail experience as a business owner or manager particularly pertaining to cannabis services proposed for this application.  Include the name, location, type of cannabis facility (e.g. manufacturing, cultivating, retail, medical, recreational, etc.) the applicant, or parties that own 10 percent or more of the business have been part of. Include years of experiences, relevant positions, etc. Specify the locations of other cannabis facilities that you own/manage or propose within one year of this application.  Alcohol-related business experience may be included. If the applicant or other interested parties have existing involvement in other operating cannabis facilities, please include façades of prior projects, marketing materials, and photographs of interior spaces. 

     Section 4 - License Status: Acknowledge the date(s) and type(s) of application that you have submitted to the State and the status of same.  Also list any other related licenses or approvals in process or already obtained.

     Section 5 - Stakeholder participation: Describe your approach to involving and hiring local residents as employees or participants in your business plan.  Include types of positions, part time/full time, starting salary requirements/ranges, training and employment initiatives such as paid time off and medical or other benefits. Clarify the importance of background checks as you consider potential employees. Describe proposal to provide community benefits to the community.  

     Areas to consider include but are not limited to:

     a.         Financial and in-kind contributions to Rahway’s drug and alcohol prevention programs, social work and mental health intervention initiatives, and other health related activities

     b.         Financial and in-kind contributions to community, civic, cultural and business associations/organizations

     c.         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

     Section 6 - Security Strategy: Describe proposed provisions for security in handling and transport of the products.  Include equipment and staff anticipated/dedicated to security related concerns, as well as background checks for staff/employees, subcontractors, etc., if applicable. Applicant’s plans for storage of products and currency, physical security, video surveillance, security personnel, and visitor management. By way of example, types of locking and entry mechanisms, estimated number of security personnel and training, type of video surveillance systems, etc.  Describe anticipated interactions with customers and security protocols that will be involved.

     Section 7 - Government, Pharmaceutical, and/or Hospital Agreements: Applicant’s or its owners’ experience conducting or supporting or plans to conduct institutional review board-approved research involving human subjects that is related to medical cannabis or substance abuse, clinical research with IRB approval shall outweigh plans to conduct such research. Many applicants have agreements with the Federal and/or state government, pharmaceutical industries, or Medical School (teaching hospitals). Examples may be agreements with Merck and/or Robert Wood Johnson in Rahway.

     Section 8 - Other Approvals: List other anticipated approvals from municipal, county, state or other agencies and anticipated timelines for each.   Municipal Planning or Zoning Board of Adjustment applications shall be included.

157. Electronic Signature Agreement*

     Completing the application form contained herein, and submitting subsequent materials required by this application, does not constitute an approval by the City of Rahway or the State.

     A Resolution of Support from the City of Rahway does not preclude or waive any other approvals from the City or any other governmental agencies.  Applicants are encouraged to consult with their attorney.

     Other approvals and permits required prior to the occupation of buildings or land within the City of Rahway include but are not limited to:

     • Completion and Execution of a Community Host Agreement with the City of Rahway
     • Planning Board / Zoning Board Approval, including completion of Resolution Compliance
     • Permits issued by the EPA, DEP, Union County, or other agency, as required
     • Building Permits and Inspections
     • Certificate of Occupancy
     • Background Checks, all employees working within Rahway shall be subject to a background check completed by the Rahway Police Department

     I have read the above requirements, and understand that this form, a resolution of endorsement from the City of Rahway, and the issuance of a State Cannabis License does not authorize occupation of a building or land within the City of Rahway. Occupation and business operations may not commence until all State and local permits and approvals have been issued in accordance with State and local laws.

     By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

     1. I agree.
159. Electronic Signature
Leave This Blank:


161. 1. Receive an email copy of this form.
162. Email address

     This field is not part of the form submission.

163. Submit

* indicates a required field