APPLICATION FOR A LICENCE TO KEEP A PET SHOP This application is made under the Pet Animals Act 1951

New application Renewal application (please tick)

Please use BLOCK CAPITALS. 1. Applicant Details Date of Birth Title (Mr / Mrs / Miss / Ms) Forename Surname Address*

Post code *If a Body Corporate, name of Body & Registered address

Email Telephone No Alt Telephone Fax Mobiles

3. Premises Details Name and address of premises Office Address (if different)

Post code: ______Post code: ______

e-mail e-mail Telephone No Telephone No Alt Telephone No Alt Telephone No Fax Fax Mobile Mobile 4. The Pet Shop Premises Please provide details for the following Size of those rooms in which busines is carried out Details of heating arrangements Method of ventilation of premises Lighting arrangements (natural/artificial) Details of water supply Arrangements of food storage Arrangements for disposal of excreta Normal times of attendance at premises when premises closed 5. Type of pets which are intended to be sold and age at which they will be sold, proposed numbers and details of accommodation Proposed Details of accommodation e.g., materials used, Age at which Type Of animals (including breed) Numbers sizes etc proposed to be sold Parrots Pigeons Other Large birds Bugerigars, finches and other small birds Puppies – supply name and address of suppliers/breeders used (use separate sheet)

Kittens Rabbits, cavies and hamsters Rats and mice Tortoises Snakes and lizards Fish Amphibians Primates – please specify Larger domesticated mammals e.g., goats, pot bellied pigs (please specify)

Arachnids Any other species (please specify) (use separate sheet if necessary)

5. Your Signature On signing this form you declare that any information you have provided is true and complete in every respect. The giving of false information may result in revocation of the licence and possible enforcement action taken against you that may result in prosecution. The fee to renew your Licence to Keep a Pet Shop is £155.30 for first applications and £76.90 for renewals.  I enclose my cheque in the sum of £155.30 / £76.90  I would like to be invoiced for the licence fee (your licence will not be issued until payment has been received) I declare my answers to the above questions to be correct in every respect Signature ______Date ______

Notes 1. A licence may be granted to an individual over the age of eighteen or a body corporate. 2. Any pet shop wishing to sell an animal covered by the Dangerous Wild Animals Act 1976 should inform the local authority 3. The Pet Animals Act 1983 specifically prohibits the sale of pets in a public place, it states “any person carrying out the business of selling animals as pets will be guilty of an offence it if takes place from a stall or barrow in a market place or pbulic place”. 4. Where the business is passed on the new proprietor can continued the licence for up to 28 days, after which the licence must be in the new proprietor’s name. A small charge may be levied for administration purposes.

This form should be returned to: Community Protection, Weymouth & Portland Borough Council, Commercial Road, Weymouth, Dorset, DT4 8NG. Data Protection Act 1998 The Council (the Data Controller) will use and manager the personal information supplied on this form for the purpose of processing your application in accordanceEmail [email protected] with that set out in the above Act. The information that you supply will be secure and protected against unauthorised access and use. If any of the information supplied, is to be processed outside of the Community Safety Team of the Council we will obtain your consent to do so. If any information is of a sensitive nature (i.e. health matters) we will always obtain your consent before it is processed. You have the right to see personal information that we hold about you. For further details contact the Councils Corporate Data Protection Officer.