2015/16 Response Services Additional animal permit application Local Law No. 1 (Administration) 2011 Local Law No. 2 (Animal Management) 2011 Application fee is $191.00 and non refundable. A permit is required to keep more than: 2 dogs over 3 months of age on a lot 2 cats over 3 months of age on a lot 6 head of poultry in an urban area on a lot that is smaller than 800m 2 in size 20 head of poultry in an urban area on a lot that is 800m 2 in size or greater Permit is applicable from 1 October 2015 – 30 September 2016 1. Applicant details Title Surname Given names Date of birth Postal address Suburb State Business phone A/H phone Postcode Mobile Email address Fax 2. Breeder details Are you a registered breeder? Yes – complete the details below No – proceed to Item 3. Breeder registration number Existing additional animal permit number (if known/obtained) Please note: if you are a registered breeder there is no fee for changing animals listed on the licence providing they are the same breed, sex and number of animals. 3. Animals address details Are you the owner of the property where the animals will be kept? Yes No* * The property owner must provide consent at time of application: the application will not be accepted without a letter from the owner indicating their approval for the additional animals. Street address Suburb Postcode Property size in m2 Is the property part of a body Yes* corporate? No m2 Property number * Body corporate must provide consent at time of application: your application will not be accepted without a letter from their body corporate indicating their approval for the additional animals. Privacy Council will use any personal information provided by you for the intended purpose only and for remaining in contact with you. Council is authorised to collect this information in accordance with the Local Government Act 2009 and other Local Government Acts. Your personal information is only accessed by persons authorised to do so. Council may provide information about you to any relevant Queensland State Department. Your personal information is dealt with in accordance with council’s privacy policy. 1 of 3 2015/16 Response Services Additional animal permit application V3 13/08/15 4. Permit reason Why would you like to keep more than the permitted number of animals: 5. Animal details Cat and dog details Type of animal Breed Colour Age Sex Microchip No Animal name M/F (dog, cat ) Tag number / Animal rego no Poultry details (group answers by breed) Number Breed Colour Sex (Male / Female) 6. Information for responsible pet ownership By lodging this application you understand: The permit is specific to the animals described above at the above-mentioned property only. Council may conduct random audits and may revoke a permit if there is non-compliance with the conditions. Council’s website contains a number of animal related fact sheets and information on responsible pet ownership. An annual renewal fee will be payable each subsequent year to renew this permit 2 of 3 2015/16 Response Services Additional animal permit application V3 13/08/15 7. Self assessment guide The guide covers some of the key criteria we may consider when assessing your application. You may like to review the criteria before submitting your application as the fee is non-refundable and it may assist you in identifying if having additional animals is suitable for your circumstances. Council retains the discretion to consider additional information when making their decision. A fully enclosed yard in which your dogs cannot escape under, over or through the fence, with a self-closing gate No regulated animals on the property No animal related local law breaches, including failure to register cats or dogs in the last two years The geography and size of the property should be appropriate for the size and number of animals to be licensed (For example: it may not be appropriate to have more than two 60kg dogs on a 500m 2 block) The existing and additional animals are not impacting on the amenity of the neighbouring properties or the community. Animal waste is disposed of and dealt with in accordance with the Environmental Protection Act 1994 and the Water Act 2000 8. Fees and charges Application fee $191.00 9. Declaration of applicant I/We, the applicant declare that the above information is correct in all respects, at the time of lodgement of this application with the Sunshine Coast Regional Council. Should any of the details given in relation to this application be changed in the future, the applicant shall advise the Sunshine Coast Regional Council in writing prior to any such change being implemented. I/We, the applicant understand that as part of assessing my application council may consult with properties in my neighbouring area. By signing this declaration I consent to council providing the animal and address details to residents in my neighbouring area for the purposes of receiving feedback on the impact of my animals. Note: Council will not disclose your name or contact information. Signature Date OFFICE USE ONLY Application no. Amount paid Date paid Receipt no. Initial Date stamp Payment options In person Customer service centres: 8.30 am to 4.30 pm Monday to Friday (excludes public holidays). By mail Cheque or money order to be made payable to: Sunshine Coast Regional Council. Cheque 3 of 3 Money order MasterCard Visa Card number Expiry date Amount $ Name on card Signature of cardholder Phone Is a receipt required? 2015/16 Response Services Additional animal permit application V3 13/08/15 Yes No