- 1 -

FOR OFFICE USE:

Fee received: £

Date:

Received by:

Method:

EALING COUNCIL

ZOO LICENSING ACT 1981 – SECTION 20

APPLICATION FORM FOR A ZOO LICENCE

(NEW AND EXISTING ZOOS)

This form should be filled in and forwarded with the appropriate fee to:

Regulatory Services, Licensing Section, Perceval House, 14/16, Uxbridge Road, Ealing, London, W5 2HL.

I/We hereby apply to the Council of the London Borough of Ealing, under the provisions of Section 20 of the Zoo Licensing Act 1981, for a Zoo licence within the Borough commencing on ……………………………………………
PREMISES TO BE LICENSED:
Trading Name: ……………………………………………………………………………….………………………………
Address: ……………………………………………………………………………………………………………………..
………………………………………………………………………………………………………………………………...
Post Code: …………………………………………………. Telephone No: ………………………………………….
APPLICANT(S): Is the proposed licence holder (please tick appropriate box)

Individual/Sole Trader (please complete Section 1 below)
Partnership (please complete Section 2 below)
Limited Company (please complete Section 3 below)
Section 1 - If applying as an Individual/Sole Trader:
Mr / Mrs / Miss / Ms (Delete as applicable)
Full Name: ………………………………………………………………………………... Age: ………………..
Private Address: ……………………………………………………………………………………………………………
………………………………………………………………………………………………………………………………...
Post Code: …………………………………………………. Telephone No: ………………………………………….
Section 2 - If applying as a Partnership:
Partner:
Mr / Mrs / Miss / Ms (Delete as applicable)
Full Name: ………………………………………………………………………………... Age: ………………..
Private Address: ……………………………………………………………………………………………………………
………………………………………………………………………………………………………………………………...
Post Code: …………………………………………………. Telephone No: ………………………………………….
Partner:
Mr / Mrs / Miss / Ms (Delete as applicable)
Full Name: ………………………………………………………………………………...
Private Address: ……………………………………………………………………………………………………………
………………………………………………………………………………………………………………………………...
Post Code: …………………………………………………. Telephone No: ………………………………………….
Name and private addresses of all partners must be given in full. If more than 2 partners please continue on separate sheet of paper.
Section 3 - If applying as a Limited Company:
Registered Company Name: ………………………………………………………………………………………………
Registered Number: ……………………
Registered Address: ………………………………………………………………………………………………………..
…………………………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………………………
Post Code: ……………………………………………..Telephone No: …………………………………………..
Name and private addresses of all directors must be given in full. If more than 2 directors please continue on separate sheet of paper.
Director:
Mr / Mrs / Miss / Ms (Delete as applicable)
Full Name: ………………………………………………………………………………...
Private Address: ……………………………………………………………………………………………………………
………………………………………………………………………………………………………………………………...
Post Code: …………………………………………………. Telephone No: ………………………………………….
Director:
Mr / Mrs / Miss / Ms (Delete as applicable)
Full Name: ………………………………………………………………………………...
Private Address: ……………………………………………………………………………………………………………
………………………………………………………………………………………………………………………………...
Post Code: …………………………………………………. Telephone No: ………………………………………….
Section 4 – Zoo Information
The additional particulars with regard to the zoo and its operation, as required by Section 2(2) of the Act are as follows:-
  1. Section 2(2)(a) – Animals
  2. Taxonomic category of Order and appropriate number of each group
…………………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………………
Note:As an alternative to listing on this form a proposed stock list may be attached.
b.AccommodationGive brief details of the animal accommodation provided (i.e. the number, type, approximate size, and security of enclosures, including confined quarters during the night or winter, and the grouping of animals).
…………………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………………
Note:If preferred, this information may be submitted in the form of annotated drawings or plans. In any event, a plan showing the layout of the zoo should be included.
  1. Maintenance and Well-being
Give brief details of arrangements for the animals’ maintenance and well-being, including information about the provision, storage and preparation of food, and arrangements for veterinary care, including preventative measures.
…………………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………………
  1. Section 2(2)(b) – Staff
  2. Staff numbers and categories
Give details of the numbers and categories of staff employed in the zoo:
Senior administrative staff under director/manager
Other administrative staff
Keeper staff
Maintenance staff
Others (please specify below)
………………………………………………………………………………………………………………………………
………………………………………………………………………………………………………………………………
  1. Section 2(2)(c) – Visitors and Motor Vehicles
Approximate number of visitors who can be accommodated per day
Type and size of car parking facilities (if any)
Safari Parks – approximate number of vehicles which can be accommodated per day
  1. Section 2(2)(d) - Access
Give details of the approximate number and position of the means of access provided to the premises.
…………………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………………
Note: if preferred this information may be submitted in the form of an annotated drawing or plan.
I am aware of the provisions of Section 20 of the Zoo Licensing Act 1981and I apply for a zoo commencing on
…………………………………
I enclose:
Completed application form
Supporting documents/other information as indicated in Section 4
The appropriate fee of £
Read the following statement carefully before signing it. A false statement may render you liable to prosecution.
I declare my answers to the above questions to be correct in every respect:
Signed: ………………………………………………………
Date: ………………………………………………………..
Designation if signing on behalf of a company or partnership
…………………………………………………………………………………………………………………………….
FORM FOR NOTICE OF INTENTION TO APPLY FOR A ZOO LICENCE (NEW ZOOS AND EXISTING ZOOS SUBJECT TO A DIRECTION UNDER SECTION 6(1)(b) OF THE ACT).I/We …………………………………………………………………………………………………………………………
of …………………………………………………………………………………………………………………………….
hereby give notice that in not less than two months after the publication in one local and one national newspaper of this notice I/We intend to make an application to EALING COUNCIL for a licence to operate a proposed zoo at:
…………………………………………………………………………………………………………………………………
A written notice of intention to make an application for a zoo licence, giving details about the proposed zoo, has been sent to the said Council. This may be inspected, free of charge at the offices of the Council at
………………………………………………………………………………………………………………………………….
Between the hours of ……………………………….. and ………………………………………
Signed …………………………………………… Date …………………………………………
Capacity (if signing on behalf of a partnership or limited company) ……………………………………………………..

Y:\Jadu Licensing\Zoo Application Form.doc