HomeMy WebLinkAboutApplication /�? TOWN O YARMOUTH
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MAATTACNEHE E8E - � � ,
innTelephone(508)398-2231, ext. 1241
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Fax(508)760-3472 ! `' %L== '
OCT 18 2019
APPLICATION FOR OPERATION - 2019
POULTRY HEALTH DEPT.
PLEASE COMPLETE ALL QUESTIONSEMAIL ‘1"-CIrtc.I s .1e`� C1/9
Colevi
NAME AS 1e5 SiG*Vl G HOME TEL.NO. 714 - cfc14 -73�I Z
LOCATION ADDRESS q3 W l 1/l.'A &t-. \/cAir u t1- P o ri-
MAILING ADDRESS(IF DIFFERENT)
NUMBER OF FOWL NUMBER OF PENS/COOPS NUMBER OF ROOSTERS 0
PLEASE NOTE: PLEASE DO NOT INCREASE THE NUMBER OF FOWL
WITHOUT PRIOR PERMISSION OF THE HEALTH DEPARTMENT.
TYPE OF SHELTER WOO al- SIZE OF YARD/PEN AREA 13 x
(WOOD,CONCRETE,ETC.)
NUMBER OF WATER OUTLETS 2. WATER TROUGHS Z-
TYPE OF STORAGE FACILITY USED FOR FEED/GRAIN Stales l-GSS Co-til
TYPE OF FACILITY USED FOR MANURE STORAGE to r✓ 0.(/IL o-C (/) aroL
METHOD OF DISPOSAL OF MANURE whec,119a rro-V-) HOW OFTEN 2x
PEN AREA ENCLOSED BY WHAT TYPE OF FENCING? rn ei 2
)( RENEWAL
NEW APPLICATION- IF NEW APPLICATION, PLEASE ATTACH A COPY OF PLOT PLAN SHOWING LOT
LINES AND LOCATION OF STABLE, PEN, ETC., AND ALL ENCLOSURES. ALSO, A
WRITTEN LETTER OR STATEMENT,SIGNED BY ALL ABUTTERS TO PROPERTY.
Town of Yarmouth taxes and liens must be paid prior to renewal or issuance of your permits.
-- Please check appropriately if paid: Yes No
SIGNATURE V► C(177 , DATE 4/2.1-1
/ I q
THE FULL POULTRY COUN IS NOT TO EXCEED THE AMOUNT OF PRIOR YEAR'S TOTAL.
FEES: V POULTRY: 1-9 chickens 1 11
10 or more Chickens 40.01
ROOSTER (NOTE: SPECIAL APPROVAL REQUIRED FOR ROOSTERS)
NO ROOSTER
TOTAL DUE: $ 40.06
11/07/18
