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File Ref: HS/42/

PET ANIMALS ACT 1951 APPLICATION FOR LICENCE TO KEEP A PET SHOP

Name (s)

I/We* .............................................................................................................. .........................................................................................................................

Address

of .................................................................................................................... ......................................................................................................................... .........................................................................................................................

being (proposed)* occupier(s)* of the premises

Address of Premises

.......................................................................................................................... .......................................................................................................................... ..........................................................................................................................

Postcode Telephone

.......................................................................................................................... ..........................................................................................................................

HEREBY make application to the City of Sunderland in pursuance of the provision of Section 1, The Pet Animals Act 1951 for a LICENCE TO KEEP A PET SHOP at those premises, particulars of which are detailed in Schedule 1 to this application; the types and details of pets intended to be sold being detailed in Schedule 2 to this application. I have not been disqualified from keeping a pet shop, from keeping an animal boarding establishment, from keeping a dog nor the custody of animals. I/We* enclose the sum of £ being the amount of the fee payable on the licence for which this application is made.

I/We* DO HEREBY CERTIFY that to the best of my/our* knowledge and belief the particulars given above and in the enclosed schedules are true.

Date Signed

............................................................................………................................. ........................................................................................................................ ........................................................................................................................ (if company or partnership state capacity)

* Delete as appropriate

This application must be returned to:Community and Cultural Services P.O. Box 107 Civic Centre Sunderland SR2 7DN

This authority is under a duty to protect the public funds it administers, and to this end may use the information you have provided on this form for the prevention and detection of fraud. It may also share the information with other bodies responsible for auditing or administering public funds for these purposes.

APPLICATION FOR LICENCE TO KEEP A PET SHOP SCHEDULE 1 Particulars of premises to which application relates ROOM SIZE METHOD OF VENTILATION LIGHTING METHOD OF HEATING

Water Supply : Washing Facilities :-

Number: Number:

Sinks ................................ Wash Hand Basins ..............................

hot and cold water hot and cold water

Yes/No* Yes/No*

Sanitary Accommodation :Number: Number: Water Closets .................................. Water Closets ................................ Male Female

Food Storage :

Arrangements for disposal of excreta and used bedding:

APPLICATION FOR LICENCE TO KEEP A PET SHOP Normal attendance at times when premises are closed: Sundays Bank Holidays Other (give details) a.m. a.m. a.m. p.m. p.m. p.m.

Comments: (give details of any matter you consider relevant to this application)

SCHEDULE 2 Type of Animals Maximum numbers to be accommodated Details and size of Accommodation Age at which to be sold

Parrots Budgerigars Other small birds Pigeons Other large birds Dogs Cats Rabbits (large varieties) Rabbits (dwarf varieties) Cavies Hamsters Rats, mice & Gerbils Tortoises Snakes Lizards Spiders Tropical Fish Marine Cold Water

Other Species


				
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Description: Receipt No File Ref HS