WASTE & REGULATORY SERVICES Application for Approval Keeping more than maximum number of animals Bundaberg Regional Council Subordinate Local Law 1.

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Barnard Marshall
7 years ago
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1 WASTE & REGULATORY SERVICES Application for Approval Keeping more than maximum number of animals Bundaberg Regional Council Subordinate Local Law 1.5 This application is to be lodged when applying to keep animals that require approval under Schedule 2 of Council s Local Law No. 2 (Animal Management) Incomplete applications will not be accepted. PART A Application Type 3 dogs on land smaller than 40,000 m2 3 cats on an allotment More than 1 dog on a multi-residential property More than 1 cat on a multi-residential property PART B Applicant Details 1 Applicant Individual s full name Title Surname/Family First Middle 2 Residential Address Shop No. Street No. Street Suburb Postcode 3 Postal address 4 Contact details Phone number Fax number Mobile No. PART B Premise Address 1 Premises Address Use official address of premises location Unit No. Street No. Street Suburb Postcode 2 Real Property Description Lot Plan Lot Plan FM Rev.5 31/10/13 P1 of 5

2 PART C Application Specific Details 5 How many animals are you applying to keep on the property? Dogs Cats 6 What size is the enclosed area you will provide for the exercise of your animals? 7 Describe the type of fencing or enclosure that will contain the animals. Include the material and height of fences, enclosures etc. 8 Description of animals to be kept on the property (attach additional sheets if necessary). Please include proof of desexing or microchipping with your application. Gender Male Female Is the animal desexed? Yes Gender Male Female Is the animal desexed? Yes FM Rev.5 31/10/13 P2 of 5

3 Gender Male Female Is the animal desexed? Yes Gender Male Female Is the animal desexed? Yes 9 Has a Council Officer ever been to your property regarding your animals? 10 Explain why you wish to keep more than the maximum number of animals attach additional sheets if necessary. 11 Council will approach neighbouring properties regarding your application. Do you have any concerns for this to happen? Yes Provide reasons FM Rev.5 31/10/13 P3 of 5

4 PART D Declaration & Signature 12 Property Owner s Consent I/we being the owners of the property described in this application hereby offer no objection to this application. Full of Signatory Signature and date / /20 13 Applicant suitability statement, declaration and signature Have you been convicted of a breach of any local laws in relation to the keeping of animals? If the applicant is a corporation or incorporated association, an executive officer of the corporation or a member of the association s management committee is included. Have you been refused a permit, licence or approval under a Local Law or corresponding law? If the applicant is a corporation or incorporated association, an executive officer of the corporation or a member of the association s management committee is included. I/we understand that the information provided in and with this application, may be disclosed publicly under the Right to Information Act 2009 and Information Privacy Act 2009 as amended from time to time or if repealed then their substitutes. I am aware that it is an offence to knowingly provide false or misleading information. Full of Signatory Position of Signatory e.g. Owner, Manager Signature and date / /20 FM Rev.5 31/10/13 P4 of 5

5 APPLICATION LODGEMENT: Applications may be lodged as follows: By scanned copy with signatures only By Post: Mail to Bundaberg Regional Council, By Fax: In person: with signatures only At your local Customer Service Centre between 8:15 am and 4:45 pm Monday to Friday - Bundaberg Administration Centre, 190 Bourbong Street, Bundaberg - Bargara Service Centre, 160 Hughes Road, Bargara - Childers Service Centre, 45 Churchill Street, Childers - Gin Gin Service Centre, 4 Dear Street, Gin Gin BUNDABERG REGIONAL COUNCIL USE ONLY CUSTOMER SERVICE Receipt Type 202 GL Receipt Number Date Paid FM Rev.5 31/10/13 P5 of 5

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