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2. Anoka County Cannabis and Hemp-derived Edibles Retail Registration Form

   Submission and approval of this form is a requirement for all businesses in Anoka County operating under one of the following license types issued by the Minnesota Office of Cannabis Management:

   License Type	Initial Registration Fee	Registration Renewal Fee
   Microbusiness License	$0	$500
   Mezzobusiness License	$500	$1,000
   Retailer License	$500	$1,000
   Medical Combination License	$500	$1,000
   Lower-potency Hemp Edible Retailer	$125	$125

   Instructions:

   • Complete all sections of this form.
   • Attach all required documents.
   • Applications without all supporting documentation will be considered incomplete, and will not be processed.
   • Submit this form to the designated local authority with the required application fee.
4. Applicant

   (Check One)

   1. First Time Applicant
   2. Renewal
6. Section 1: Applicant Information
8. Property Owner Full Name:*
9. Applicant Full Name:*
11. Property Owner Address:*
12. Applicant Address:*
14. Email Address:
15. Telephone Number:
17. Select registration type:*
    -- Select One --Microbusiness LicenseMezzobusiness LicenseRetailer LicenseMedical Combination LicenseLower-potency Hemp Edible Retailer
19. If registration payment will be made by someone other than the applicant, include their name, address, and contact information here.
21. Section 2: Property Information
23. Retail Property Address (for Retail Registration):
25. Parcel ID Number:
27. Attest

    I attest that all property taxes and assessments are current at the location where the retail establishment will be located.

    1. I certify
29. Section 3: Certifications and Verifications
31. Certification of Compliance with Local Ordinances*

    By checking this box, I certify that I currently and will continue to comply with the requirements of all applicable statutes and local ordinances established pursuant to Minn. Stat. §342.13. 

    1. E-Signature
33. Fire Code Compliance

    If available, attach evidence that building plan has been submitted for fire review. For a renewal, provide evidence that building has received Certificate of Occupancy.

    1. E-Signature
35. Building Code Compliance*

    I certify that the retail establishment has been inspected and complies with all applicable building codes.

    1. E-Signature
37. Educational Materials Verification*

    I attest that this establishment will provide and display educational materials regarding cannabis and other substances, including:

    • Safer use information.
    • Community cessation resources.
    • Penalties for underage sales.
    • Age verification requirements.
    • Legal sales age.

    Signage will be provided by the County after approving this application.

    1. E-Signature
39. Tax Certification

    I certify that the applicant is current on all property taxes and assessments at the location of the retail establishment.

    1. E-Signature
41. Section 4: Additional Requirements (for Business Entities)
43. Business Registration

    Please attach evidence of business registration with the Minnesota Secretary of State.

45. Section 5: Prohibited Practices
47. Certification of No Vending Machines or Self-Service Displays*

    I attest that the establishment will not sell or offer cannabis products through vending machines or self-service displays. All sales will be conducted from behind a counter.

    1. E-Signature
49. Section 6: Naloxone Distribution
51. Naloxone Distribution

    This business will consider becoming a Naloxone distribution location?

    1. Yes
    2. No
52. * Participation in the Anoka County Naloxone distribution program is not a requirement for approval, and declining to participate will not influence the approval process. *

    For more information on Anoka County's Opioid Solutions Initiative, please visit our page on Opioid Response.

    1. E-Signature
54. Section 7: Acknowledgement and Submission*

    I affirm that all information provided in this application is true and complete to the best of my knowledge.

    1. E-Signature
58. Application Fee:

    Upon receiving the application, the County will invoice the contact in Section 1 for the registration payment, as specified in the Anoka County fee schedule. Fees are non-refundable, and no application will be approved until it is received. 

Leave This Blank:


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

    This field is not part of the form submission.

62. Submit

* indicates a required field