PET ANIMALS ACT 1951 (AS AMENDED) – SECTION 1
APPLICATION TO KEEP A PET SHOP
I/We (Full Name and Title):
of (Address):
Telephone Number:
Mobile Number:
E-mail address:
HEREBY MAKE APPLICATION in pursuance of Section 1 of the Pet Animals Act
1951 (As Amended), for the licence to keep a PET SHOP at:
Please insert full postal address if different from above
For the following section of this application ANSWER ALL QUESTIONS IN FULL.
1.
Full description of quarters (including Dimensions) housing the animal(s)
2.
Types of animal(s) and/or birds which are intended to be stocked (include ages
at which type can be sold):
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3.
Heating arrangements:
4.
Lighting arrangements:
a) Natural
b) Artificial
5.
Ventilation arrangements:
6.
Food storage facilities:
7.
Arrangement for waste disposal.
i.e. Excreta, bedding, etc …
8.
Water supply:
9.
Is a record kept on source of stock?
YES/NO
10. Is a record kept of persons to whom
Animals or Birds are sold?
YES/NO
11. Is the applicant over 18 years of age?
YES / NO
12. Name, and address and telephone number of Veterinary Surgeon:
13. Explain fire precautions in place:
14. a)
b)
Will there be a permanent watch on the premises?
YES / NO
If not, please give details of proposals as to how fire and other emergencies
are to be dealt with in the absence of any responsible person from the
premises:
Although the licence may be issued, it is necessary for you to obtain the relevant
planning consent(s).
15.
Will this development require planning consent?
YES/NO
16.
Have you obtained relevant Planning Permissions?
YES/NO
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17.
Details of insurance(s) cover:
Name of the Company:
Telephone Number:
Address of Company:
Postcode:
Please enclose your Certificate of Insurance (i.e. Public Liability and/or
Employers Liability Insurance) or copy.
I/WE ENCLOSE HEREWITH the sum of £
fee payable on the licence applied for.
being the amount of the
I/WE ENCLOSE HEREWITH a certificate(s) of insurance(s) (or copy).
DECLARATION
I have not been disqualified from holding a licence under any of the Animal Welfare
Acts, namely Animal Boarding Act 1963, Breeding of Dogs Act 1951 (as amended),
Riding Establishments Acts 1964 and 1970, and the Dangerous Wild Animals Act
1975.
I understand that a licence can only be granted if the Council is fully satisfied with
the answers I have given in completing this application.
I confirm that I have answered the questions truthfully to the best of my knowledge
and belief. I agree to the Council’s Officers making any enquiries necessary to verify
the information given by me including reference to relevant records and registers,
nominated referees and any relevant recognised bodies or organisations.
I make this application and I have answered the above questions knowing that if the
licence is granted, I shall be liable to prosecution if I have wilfully stated in any
answer anything which I know to be false or do not believe to be true.
Date:
Signed:
Position in Company if signing on behalf of
a Company or Partnership
This form when completed should be returned to:
Head of Finance
Waverley Borough Council
Council Offices
The Burys
Godalming
Surrey
GU7 1HR
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Date of inspection:
Time of inspection:
Person Interviewed:
Recommendation(s):
Conditions, if any:
Plan/drawing of the premises:
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Date:
Signature:
Officer’s name:
OFFICIAL USE ONLY
This is not an official receipt
CODE 04642
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£
P
VAT