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APPLICATION FOR A DANGEROUS WILD ANIMALS LICENCE

Isle of Wight Council

Application For A Dangerous Wild Animals Licence

Dangerous Wild Animals Act 1976

You will be required to provide:

(a) a location plan (scale 1:2500)

(b) a site plan showing all structures, shelters, enclosures and fencing (scale 1:500)

(c) TWO copies of the Public Liability Insurance

I understand that:

(a) the licence fee does not include the cost of the veterinary inspection and this will be recovered
from me after the issue of the licence; and
(b) the issue of a Dangerous Wild Animals Act licence does not convey or imply any rights under
planning permission.

The giving of false information may result in registration being refused or revoked, and the local authority reserve the right to make such further enquiries arising out of this application as they may consider desirable.

This licence fee is not refundable in the event of the application being refused or otherwise.

I hereby apply for a licence under the Dangerous Wild Animals Act 1976 in respect of which I enclose

the fee of �..........................

Please read:

Conditions for the Licence

Please tick this box to confirm you have read and accept the terms and conditions

Commercial premises

Domestic premises

Cost T£365.00 (inclusive of vet fees)

Cost T£315.00 (inclusive of vet fees)

Personal details

*	Forename(s)
*	Surname

*	Building/house name/number
*	Street
*	Town
	County
*	Postcode
	Telephone number (include area code)
	Email address
	Fax

Address of premises where the animals are to be kept

Is the address where the animals are to be kept the same as that specified above?

Yes No

Building/house name/number

Street

Town

County

Postcode

Home telephone number
(include area code)

Work telephone number
(include area code)

	Details of animals
	Specify the type(s) of animal to be kept and how many

Type	Number Male	Number Female

Do you own and keep all the animals listed above?

Yes

If no, please give details of ownership and possession

Is it intended to breed or attempt to breed from these animals?

Yes

If yes, please provide details

	Accommodation details
	Please give the following information about the accommodation in which the animals listed above will be held. (Please refer to the conditions for further information)

	Construction (include fencing and security arrangements)
	Size

Arrangements for:-

	temperature control
	lighting
	ventilation
	drainage (if animals are to be kept in open paddocks, etc, give details of soil type and field drainage)
	cleanliness

	the provision, storage and preparation of food and drink
	bedding material
	ensuring adequate exercise
	prevention and control of infectious diseases (please identify the veterinary surgeon you intend to use)
	dealing with fire or other emergencies (include details of arrangements to be made for supervision in the absence of the licensee)
	visiting at suitable intervals

Please provide details of any training and/or practical experience in handling the animals concerned of yourself or staff

Have all necessary planning permissions been obtained?

Yes

If yes, please quote reference numbers

Please provide details of the insurance proposed against liability for any damage caused by the animals (public liability insurance may be necessary)

Please indicate whether you have ever been convicted of any offence under the following legislations:

Protection of Animals Acts 1911-1964

Protection of Animals (Scotland) Acts 1912-1964

Pet Animals Act 1951

Animal Boarding Establishments Act 1963

Riding Establishment Acts 1964 and 1970

Breeding of Dogs Act 1973

Dangerous Wild Animals Act 1976

Any other animal welfare legislation

Yes

If 'Yes' please give details:

	You will be required to provide:
	(a) a location plan (scale 1:2500) (b) a site plan showing all structures, shelters, enclosures and fencing (scale 1:500) (c) TWO copies of the Public Liability Insurance

	Declaration
	I declare that I have read the above conditions and agree to observe and perform them and that the information given by me on this application is correct to the best of my knowledge and belief. I fully understand that the withholding of relevant information or any false or misleading statement may result on the refusal or revocation of the licence and/or prosecution. Signed ............................................................................... Name................................................................................. Date...................................................................................
	This form must be signed and all the relevant documents, detailed on the form, presented to the licensing section before a decision is made and the licence may be granted. Either print off the completed form, sign and post to the licensing department along with the required documents or attend council offices after you have submitted the form online.
	The licence fee is not refundable in the event of the application being refused or otherwise.

	FOR OFFICIAL USE ONLY
	Date application received..................................................... Receipt No......................................................................... Amount paid......................................................................

Data Protection Act 1998

This application may be monitored by the Isle of Wight Council for regulatory, quality control or crime detection purposes. Information from this application will be processed in accordance with the Data Protection Act 1998 for the purpose of processing your particular enquiry/request. The Isle of Wight Council ("the Council") is the data controller. By completing this form you consent to the Council contacting you by email or nominated contact method in relation to your enquiry/request.

The information contained in this application may, in exceptional circumstances, be subject to disclosure to third parties under either the Data Protection Act 1998 or the Freedom of Information Act 2000 to the extent the law allows and in accordance with the Isle of Wight Council's Access to Information Policy . Disclosure will only be made where in all the circumstances it would be fair to do so and in the public interest.

Please note that the Council may process your information in the absence of consent for the purpose of crime prevention or detection so far as is in accordance with the law.

Sometimes we may use your information to keep you informed about services, goods or relevant issues that we believe may be of interest to you. If you wish to receive this information for these purposes please tick this box

To improve the quality of other services that we provide to you the Council wishes to hold your non-sensitive personal information on a secure central database. This will enable all Council services to use this information when they are providing a service to/for you. If you wish your non-sensitive personal information to be held by the Council please tick this box

Product	Cost	VAT code	GL Code
Commercial Dangerous Wild Animals Licence	£365.00	AN	67605732501
Domestic Dangerous Wild Animal Licence	£315.00	AN	67605732501

Date printed: 07/03/2013