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Pet Animals Act 1951 (as amended) Application for a licence to keep a Pet Shop ___________________________________________________________________ Please send completed applications to:Wigan Council, Licensing Section, Town Hall, Library Street, Wigan, WN1 1YN ___________________________________________________________________ Type of Application First Grant Renewal of Existing Licence Applicants Details I / We Of (home / registered address) Tel No. as [occupier(s)] [proposed occupier(s)]* of the premises mentioned below, hereby apply for a Licence to keep a Pet Shop under the provisions of Section One of the Pet Animals Act 1951 at those premises. * delete as appropriate I / We enclose the fee payable for the licence for which this application is made. (Please make cheques payable to “Wigan Council”) Details of premises for which application is made Name of Business Details of premises for which application is made cont’d… Full postal address (inc. postcode) Telephone Number Opening hours Number and size of rooms in which business will be carried out Heating Arrangements Method of Ventilation Lighting Arrangements (both natural & artificial) Water Supply Food Storage Arrangements Arrangements for disposal of excreta and waste Signed ………………………………………………………………………… Print Name ………………………………………………………………………... Date ………………………………………………………………………… Position (state capacity if applying on behalf of a company or partnership) ………………………………………………………… Please provide details of the pets to be sold, age at which they are to be sold and their accommodation on the Schedule overleaf Schedule of pets to be sold Type of Animals Proposed Numbers Budgerigars, finches and other small birds Other large birds Parrots Pigeons Cats Dogs Hamsters Rabbits and cavies Rats, mice and gerbils Snakes and lizards Tortoises Fish – Cold water Fish – Marine Fish – Tropical Any other species (please specify) Normal times of attendance at premises when they are closed Details of Accommodation Age at which to be sold Is any person named on this form disqualified from the keeping of any animal under the Protection of Animals Act 1911 (as amended) or the Protection of Animals (Scotland) Act 1912 (as amended)? Is any person named on this form disqualified from the keeping a Pet Shop? Yes No Yes No If yes, please give details:- I / We certify that to the best of my / our knowledge and belief, the particulars set out on this application are true. Signed ………………………………………………………………………… Print Name ………………………………………………………………………... Date …………………………………………………………………………