ANIMAL BOARDING ESTABLISHMENTS ACT 1963, s.1
APPLICATION FOR A LICENCE TO KEEP A HOME BOARDING ESTABLISHMENT
1. Name of applicant(s)
Surname(s)
Forename(s)
Title
2. Premises address
Postcode
3. Premises details
Type of property
Please tick as
appropriate
Telephone number
Bungalow
Are there any children living in the property?
If the answer is YES then please state ages:
House
Terraced
Detached or
Semi detached
YES/NO (Delete as appropriate)
Does the property have a garden? If YES please
give approximate size
Does the garden have a back yard? If YES please give
approximate size
YES/NO
YES/NO
4.
Number, construction and size of quarters in
which animals (are) (will be) accommodated?
5.
Types of animals which are (intended to be)
accommodated on the premises?
6.
Heating arrangements?
7.
Method of ventilation of premises?
8.
Lighting arrangements:
Natural / artificial?
9.
Water supply?
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10.
Arrangements for food storage?
11.
Arrangements for disposal of excreta?
12.
Description of isolation facilities for the
control of infectious disease?
13.
Name and address of usual veterinary
surgeon?
14.
Fire precautions and equipment?
15.
Is any person named in this form disqualified
from:
a) keeping a dog
b) having custody of animals
c) keeping a Pet Shop
d) keeping an Animal Boarding
Establishment
If YES to any of the above, please give
details
16.
Do you intend to provide a delivery/collection
service for animals
Please delete as appropriate
YES
YES
YES
YES
NO
NO
NO
NO
YES/NO Please delete as appropriate and give details
17. Signature of applicant(s)
Date
The fee for this licence is £135.00.
Please tick
below if a
Cheque is
enclosed:

Please post this form with a cheque to: The Licensing Office, Wyre Council, Breck
Road, Poulton le Fylde, FY6 7PU.
Cheques should be made payable to WYRE COUNCIL and returned with this
application form or include a contact number we can phone to arrange the process of a
card payment.
If you require any further information please contact us by Email:
licensing@wyre.gov.uk
For Official Use
Date of Inspection
Signature of Officer
Rev06
Page 2 of 2
Recommendations
Passed to Licensing (date)