For Office Use: Flare Number
ANIMALS
ACT
1951shop
ApplicationPET
for Licence
to keep
a pet
I/WE HEREBY MAKE APPLICATION for a licence to keep a pet shop in pursuance of the
provisions of Section 1 of the Pet Animals Act 1951 at the premises detailed below:SECTION A – THE APPLICANT(S)
Full Name
Mr/Mrs/Miss/Ms*
* please delete as necessary
Home Address
Postcode
Tel
Mobile
SECTION B – PREMISES REQUIRED TO BE REGISTERED
Trading Name
Address
Postcode
Tel
Email
SECTION C – DESCRIPTION OF PREMISES ( INC. NUMBER AND SIZE OF ROOMS, PARTICULARS
OF ARRANGEMENTS FOR LIGHTING (NATURAL AND ARTIFICIAL) AND HEATING, METHOD OF
VENTILATION and WATER SUPPLY - use extra sheet if required)
SECTION D – ARRANGEMENTS FOR FOOD STORAGE AND DISPOSAL OF EXCRETA
SECTION E – PREVIOUS CONVICTION(S)
Have you ever been convicted of any offence under the Act? If so, give details and date
 Yes (Give details below)
 No
SECTION F – SIGNATURE
A fee of £
accompanies this application to: Stoke-on-Trent City Council, Public Health & Adult
Social Care Directorate, Public Protection Division, Hanley Town Hall, Stoke-on-Trent, ST1 1QL.
Additional fees may be sought if a veterinary inspection is carried out.
Signature
Date
d
d
m
m
y
y
[on behalf of]
For types of pets which are intended to be sold, and age at which they will be sold, proposed numbers and
details of accommodation. – See Schedule overleaf.
For Office Use: Flare Number
SECTION G – SCHEDULE
Type of
Animals
Proposed
Numbers
Details of
Accommodation
Age at
Which
Proposed
To be
sold
Inspector’s
Comments
Parrots
Pigeons
Other large birds
Budgerigars,
finches and
other small birds
Cats
Rabbits and cavies
Hamsters
Rats, mice
and gerbils
Tortoises
Snakes and
Lizards
Tropical
Fish
Marine
Cold Water
Any other
Species (specify)
Normal times of attendance at the premises when premises are closed: ………………………………………………….…
………………………………………………………………………………………………………………………………………….………..
SECTION H – FOR OFFICE USE ONLY
Date Submitted
Fee Paid
£
Receipt Number
Cheque Number