/ HARBOROUGH DISTRICT COUNCIL
APPLICATION FOR A LICENCE TO KEEP A DOG DAY BOARDING ESTABLISHMENT
ANIMAL BOARDING ESTABLISHMENTS ACT 1963

1.  Name of Proposed Licensee:

State Mr/Mrs/Miss/Ms/Other

2.Business Details
/ Trading as:
Address:

Telephone number:

/

Email Address:

/

3. Is the establishment operative throughout the year?

/

If not state period when normally operative:

/
4. Who will have direct control or management of the establishment? /

5. Are you, or any person who will have control or management of the establishment, disqualified for the time being;

(a) / From keeping a boarding establishment under the Animal Boarding Establishments Act 1963? /

Yes / No

(b) / From keeping a pet shop under the Pet Animals Act 1951 /

Yes / No

(c) / From having custody of animals under the Protection of Animals (Amendment) Act 1954 /

Yes / No

(d) / For an offence under the Animal Welfare Act 2006 or Animal Health and Welfare (Scotland) Act 2006 /

Yes / No

6. Are you the holder of a current Public Liability Insurance Policy?

/

Yes / No

7. How many DOGS are you seeking to be registered for under the terms of the Act ? /
8. What heating arrangements do you have in place in the establishment? /
9. What method of ventilation is provided? /
10. What lighting arrangements are in place?
- Natural
- Artificial /
11. Is there a water supply to the premises? /
12. What arrangements do you have in place for food storage? /
13. Please provide details of your arrangements for the disposal of excreta? Who is your trade waste contract with? /
14. Please provide a description of the isolation facilities you have for the control of infectious diseases:
/
15. What are the arrangements for the protection of animals in the case of fire?
Do you have a documented emergency evacuation plan in place and available for inspection?
Do you have smoke/fire detection in place? /
16. What is the name and address of your usual veterinary surgeon/practitioner? /

I am aware of the provisions of the Animal Boarding Establishments Act 1963 and I apply for a licence to keep an animal boarding establishment. I agree to permit a person authorised by the council to inspect the premises before any licence is granted.

I understand that this application relates to the day boarding of dogs only and that overnight boarding of dogs is not permitted. Any dogs kept overnight at my home address or any other address used to provide accommodation for dogs in connection with my business will need to be licensed separately, in accordance with the legislation.

The commencement date is-...... (if other than 1st January)

(Expiry day of existing licence is )

(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.

Date……………………. Usual Signature: ......

(if signing on behalf of a Body Corporate

state appointment held): ......

This application form should be completed and returned with the sum of £160.00

TO: Regulatory Services, Harborough District Council, The Symington Building,

Adam and Eve Street, Market Harborough, Leicestershire. LE16 7AG

Cheques should be made payable to ‘Harborough District Council’

In case of difficulty when completing this form please call 01858 828282 for help and advice.

Nd/li/boapp