Type Full Name :
Sign With Hand
Last Name
Phone #
ZIP
City
State
Email
Provide Related Documents
Premises Details
If Other
Address
Address 2
Specify the type and quantity of animals to be housed at said location
Ownership Type
Phone #
If granted this permit I shall adhere strictly to the provisions of Chapter 208 of the Municipal Code.
Business/Organization Name
License Type Fees
Kennel (10 or less dogs) $10.00
Kennel (More than 10 dogs) $25.00
Pet Shop $10.00
Total Ownership %
Emergency Contact Details
Amount Due
State
License Type
Federal ID #
Phone #
Fee Schedule
Last Name
First Name
Additional Owner Details
Address
Certification
{[ADDR]}
{[CITY]}, {[STATE]} {[ZIP]}
{[APHONE]}
{[AWEBSITE]}
Attachments
Applicant Signature
Describe Premises
Premises Owner Details
First Name
City
Will dogs be sold?
ZIP
{[PNAME]}
Application
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