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unofficial consolidation, the official version is held by the municipal clerk.
FOR OFFICE USE ONLY
Date: YYYY/MM/DD
Permit No.
Animal Ownership
Exemption Application Form
Animal Ownership Exemption Permits are required to be renewed annually
PLEASE PRINT AND COMPLETE THE ENTIRE FORM
OWNER INFORMATION
OWNER NAME:
ADDRESS:
PRIMARY PHONE # (cell, home or office):
SECONDARY PHONE #
EMAIL ADDRESS:
ANIMAL INFORMATION
TYPE OF ANIMAL(S) BEING APPLIED FOR:
NUMBER AND TYPE OF (OTHER) CURRENT ANIMALS AT THIS LOCATION (Please list all):
WHAT EXPERIENCE DO YOU HAVE WITH THIS TYPE OF ANIMAL/SPECIES BEING APPLIED FOR?
ARE THEIR REQUIRED VACCINATIONS OR SPECIAL REQUIREMENTS FOR THE TYPE OF ANIMAL APPLIED FOR?
ARE THERE KNOWN REGULATIONS FOR THIS TYPE OF ANIMAL?
WILL THIS ANIMAL BE HOUSED OUTSIDE?
YES** NO
**IF YES, PLEASE ATTACH A SITE PLAN OF LIVING
SPACE/BACKYARD FOR ANIMAL INCLUDING LOT
DIMENSIONS AND BUILDING PLANS IF APPLICABLE
CIRCLE ONE:
OWNER
TENANT***
***IF TENANT, A LETTER OF APPROVAL IS REQUIRED FROM
THE REGISTERED PROPERTY OWNER, ALONG WITH THIS
APPLICATION FORM
Further information regarding other animal ownership exemption rules & regulations can be obtained by contacting
Mayerthorpe Enforcement Services at 780.786.2416. The granting of this permit shall in no way relieve the owner from
complying with the requirements of the Animal Control Bylaw or any relevant bylaws of the Town of Mayerthorpe or
other Provincial or Federal Statutes or Regulations in force.
I acknowledge that I am required to apply for a Premises Identification Number through Alberta Agriculture and
Rural Development for all Fowl animal applications.
I certify that I will abide by all regulations after I have received my Permit, knowing that failure to comply may
result in cancellation of it (or future) permits.
Owner's Signature __________________________________________ Date:__________________________________
The personal information collected on this form is collected under the authority of Section 33(c) of the Freedom of Information and Protection of Privacy Act (sa
2000). It will be used in the operation of the Responsible Pet Ownership Bylaw No. 1104 for bylaw enforcement purposes, and shared with outside organizations for
the purpose of reuniting lost pets with owners. If you have any questions about this collection, contact the Records/FOIP Coordinator:at 780.786.2416
Town of Mayerthorpe
Box 420 Mayerthorpe, AB T0E 1N0
T: 780.786.2416 F: 780.786.4590
www.mayerthorpe.ca
FOR OFFICE USE ONLY
Date: YYYY/MM/DD
Permit No.
PAYMENT
PERMIT FEE:
$
METHOD OF PAYMENT:
Cash Cheque Debit Mastercard Visa
OWNER SIGNATURE:
DATE (YYYMMDD):
RENEWAL NOTICES will be mailed out each year.
FOR OFFICE USE ONLY
PRE-APPROVAL SITE VISIT DATE :
OFFICER
FILE #
POST-APPROVAL & RENEWALS SITE
VISIT DATE
OFFICER
IN COMPLIANCE WITH PERMIT CONDITIONS?
YES NO*
* IF NOT IN COMPLIANCE PROVIDE REASONS AND FOLLOW-UP INFORMATION TO ENSURE COMPLIANCE
FOR OFFICE USE ONLY
Date: YYYY/MM/DD
Permit No.
PERMIT NUMBER _________________ ANIMAL TYPE _________________
The following conditions must be complied with at all times in accordance with the Responsible Pet Ownership Bylaw and or
any established policies and procedures. The applicant and named person on the permit is solely responsible for ensuring these
conditions are met. All conditions must be complied with before a permit is issued
Failure to comply with these conditions will result in enforcement action taken including the possibility of revocation of this
permit, fines and impoundment of animals if required.
Maximum number of animals applied for to be located on the property at any time is __________
Must adequately identify all animals in relation to this permit as approved by an Animal Control Officer
Must have and maintain adequate housing which includes a minimum space to provide for a healthy lifestyle of the
animal
Provide adequate food, water and shelter from the elements at all times
Must comply with the Town of Mayerthorpe Land-use Bylaw for any structures on the property
Must not house any roosters
Must have permission of property owner for animals applied for if applicable
Must produce these conditions upon demand of any Peace Officer as defined by the Peace Officer Act of Alberta
Must keep the area clean and in a sanitary condition, free from Vermin and noxious or offensive smells and
substances
Keep area rodent free
Store all food in an approved container to prevent food spillage and the attractant of other animals
Follow all applicable bio-security measures as outlined by the Canadian Food Inspection Agency
All animals and their by-products is for personal use only, any sales or profiting from the animals is prohibited
Properly dispose of animals at end of life cycle or end or use cycle
Must not shelter animal in anything other than the housing as provided and approved
Must provide letter of insurance approval for the animals applied for
Must gain letter of permission from immediate neighbors affected by the application
Must provide notification to affected neighbors as directed by an Animal Control Officer
Must allow an Animal Control Officer access to the property not including dwellings for the purposes of an
inspection in accordance with the Animal Control Bylaw without prior notice during the hours of 8:00am and 8:00pm
of any day
Must provide and adhere to an adequate end of cycle plan
Must provide and adhere to an adequate end of life plan
Must provide and adhere to an adequate owner absence plan
Must provide an approved emergency and disaster contingency plan
This Permit is non-transferrable from person to person or from property to property. If the permit holder no longer resides at
the property the permit was issued for the permit is considered null and void.
This permit may be revoked by the Town of Mayerthorpe in accordance with the Animal Control Bylaw for;
-
Failing to comply with the conditions of this Bylaw
-
Failing to comply with any applicable Municipal Bylaw, Provincial or Federal Regulations.
-
Providing false or misleading information or documents in relation to this permit
-
Fail to pay any fees owed to the Town of Mayerthorpe as it relates to the Animal Control
Bylaw
-
If it is in the public interest to revoke this permit
LIST OF CONDITIONS OF PERMIT