I / WE…………………………………………………………………………………………………………………..

of……………………………………………………………………………………………………………………….

as the [proposed] occupier(s) of the premises hereinafter mentioned HEREBY MAKE APPLICATION in pursuance of the provisions of section 1 of the Pet Animals Act 1951, for a LICENCE TO KEEP A PET SHOP at the premises, of which particulars are given below.

I / WE enclose herewith the sum of £ being the amount of the fee payable on the Licence for which application is made. Please make cheques payable to Cotswold District Council

PARTICULARS

1. Postal address of the premises:…………………………………………………………………………………..

…………………………………………………………………………………………….…………………………..

2. Number and size of rooms in which business will be carried on : ……………………………………………..

3. Heating arrangements:……………………………………………………………………………………………..

4. Methods of ventilation of premises:……………………………………………………………………………….

5. Lighting arrangements (natural and artificial) : …………………………………………………………………..

6. Water supply : ……………………………………………………………………………………………………….

7. Arrangements for food storage: …………………………………………………………………………………..

8. Arrangements for disposal of excreta: …………………………………………………………………………..

9. Types of pets which are intended to be sold, and age at which they will be sold, proposed numbers and details of accommodation. - See Schedule overleaf.

I / WE DO HEREBY CERTIFY to the best of my/our knowledge and belief, the above particulars are true.

* Signed ………………………………………………………….

…………………………………………………………………… Dated ………………………..…20…

*If the applicant signs on behalf of a Company or Partnership, capacity should be stated.

The Name and Address of the Licence holder and Pet Shop address provided on this application will be transferred to a Register held at Cotswold District Council Offices, Public Protection.
If you do not consent to your name and address being given to the public please tick this box
All other information provided will be kept confidential subject to disclosure necessitated by any legal proceedings.
If an inspection of the premises is required, the information provided may be passed to a Veterinary Practitioner.
(Mrs B Patel, Data Protection Officer Tel: 01285 623000 Ext 3219)
Please return this form and fee of £ (cheques to be made payable to Cotswold District Council) to:-
Public Protection, Cotswold District Council,
Council Offices, Trinity Road, Cirencester, Glos GL7 1PX.

SCHEDULE

Type of animals / Proposed
numbers / Details of accommodation / Age at which
proposed to be sold / Inspector’s
comments
Parrots
Pigeons
Other large birds
Budgerigars, finches
and other small birds
Dogs
Cats
Rabbits and cavies
Tortoises
Hamsters
Rats, mice and gerbils
Snakes and lizards
Marine
Fish / Cold water
Tropical
Any other species
(specify)

Normal times of attendance at the premises when the premises are closed :

…………………………………………………………………………………………………

FOR OFFICE USE ONLY

Date of inspection…………………………………………

Comments……………………………………………………………………………………

…………………………………………………………………………………………………

G/Envhealth/Commercial/Denise/Printer forms/Application Pet Shop