Municipal governments are responsible for managing and regulating a variety of issues, including the permitting process for animal maintenance. The animal maintenance permit application form is one of the most important documents related to this process. This form is used to collect information about the applicant, the animals involved, and the specific details of the proposed animal maintenance program. The form must be completed in full and submitted to the relevant municipal government in order to receive approval for the animal maintenance program. Incomplete or inaccurate information may lead to delays or rejections of the application. It is important that applicants take their time completing this form accurately and honestly.
| Question | Answer |
|---|---|
| Form Name | Animal Maintenance Permit Application Form |
| Form Length | 3 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 45 sec |
| Other names | unbuilt, sedgwick, designee, revocation |
POLICE DEPARTMENT – ANIMAL CONTROL SECTION 3303 N. HILLSIDE – WICHITA, KS. 67219
ANIMAL MAINTENANCE PERMIT APPLICATION
Submit application, required documentation & payment to: |
Wichita City Hall |
Allow 30 days for processing |
455 N. Main - Express Office 1st Floor |
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Wichita Ks. 67202 |
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Indicate Type of Animals Maintained at Property - No more than three types of animals allowed on premises.
Dogs |
Cats |
= $25.00 |
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Rabbits |
= $25.00 |
Pig (1 Neutered, Miniature Vietnamese |
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Fowl |
= $25.00 |
Horses (1 per acre) |
= $100.00 |
Cattle (1 per acre) |
= $100.00 |
Sheep (1 per acre) |
= $100.00 |
Goats (Nannies only, 1 per acre) |
= $100.00 |
Ratites (1 per acre) |
= $100.00 |
Other |
= $100.00 |
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NOTE: Cost of permit is based on the single highest priced permit fee for the selected types of animal on premises.
SECTION 1 – OWNER INFORMATION
Name of Owner
Address of Owner
City / State / Zip
Date of Birth
Phone Number
Address where animals will be kept (if different from owners address):
Lot size of premises where animals are maintained: |
Fenced yard? |
Yes |
No |
Total sq. ft |
Fenced run? |
Yes |
No |
SECTION 2 – VETERINARIAN INFORMATION
Veterinarian Name:
Address:
Clinic Name:
Phone:
SECTION 3 – ANIMAL INFORMATION & RABIES VACCINATION STATIS
#1 |
Name: |
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#2 |
Name: |
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Type/Breed: |
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Type/Breed: |
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Color: |
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Color: |
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Sex: |
Male |
Neutered |
Female |
Spayed |
Sex: |
Male |
Neutered |
Female |
Spayed |
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Rabies Vaccination Date: |
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Rabies Vaccination Date: |
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Microchip #: |
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Microchip #: |
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#3 |
Name: |
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#4 |
Name: |
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Type/Breed: |
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Type/Breed: |
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Color: |
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Color: |
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Sex: |
Male |
Neutered |
Female |
Spayed |
Sex: |
Male |
Neutered |
Female |
Spayed |
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Rabies Vaccination Date: |
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Rabies Vaccination Date: |
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Microchip #: |
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Microchip #: |
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SECTION 4 – ADDITIONAL INFORMATION (If more than four animals, list additional information)
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#5 |
Name: |
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#6 |
Name: |
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Type/Breed: |
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Type/Breed: |
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Color: |
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Color: |
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Sex: |
Male |
Neutered |
Female |
Spayed |
Sex: |
Male |
Neutered |
Female |
Spayed |
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Rabies Vaccination Date: |
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Rabies Vaccination Date: |
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Microchip #: |
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Microchip #: |
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#7 |
Name: |
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#8 |
Name: |
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Type/Breed: |
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Type/Breed: |
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Color: |
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Color: |
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Sex: |
Male |
Neutered |
Female |
Spayed |
Sex: |
Male |
Neutered |
Female |
Spayed |
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Rabies Vaccination Date: |
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Rabies Vaccination Date: |
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Microchip #: |
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Microchip #: |
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SECTION 5 – DRAWING OF PROPERTY
(Indicate property line, location of residential dwelling, animal shelter, fencing and show animal waste storage area and drainage paths for animal waste)
N
W E
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SECTION 6 – REQUIREMENTS
1.Applicant must furnish all required documentation before application will be accepted.
2.Applicant must provide proof of current rabies vaccine for all dogs and cats. Vaccination must be administered by a licensed veterinarian per City Code requirements as specified in 6.04.110 of the City Code. Applicant must provide proof of current dog licenses as required in Chapter 6.04 of the code of the City of Wichita.
3.Not more than one head of livestock shall be kept for each acre of unbuilt land area. Enclosures for large animals must be 200 feet from adjacent dwellings and twenty feet from the property line. Stables, coops, pens and other structures for the housing of animals shall comply with all zoning requirements of the City of
4.Per Wichita/Sedgwick Co. Unified Zoning Code and Chapter 6.04 of the City Code, it is unlawful to breed and sell animals in residentially zoned areas in the City. Issuance of this Permit does not authorize the Permit Holder to breed or sell animals. A separate Breeder’s License application must be submitted to permit breeding and sale of animals.
5.Applicant must comply with all City of Wichita and State of Kansas ordinances, statutes, and regulations pertaining to the care, maintenance, keeping, and management of domestic animals.
I have read and understand the above requirements pertaining to the acquisition of an Animal Maintenance Permit and agree to comply with all requirements set forth by applicable ordinances and policies established by the City of Wichita. I agree to allow the Chief of Police or their designee, access to the property where my animals are owned, kept, or harbored for the purpose of inspection and verifying compliance with the regulations and ordinances pertaining to proper animal care and maintenance. If I am granted an Animal Maintenance Permit, I understand that failure to comply with the regulations set out in Chapter 6.04 of the Code of the City of Wichita may result in my permit being revoked for a minimum of 24 months. If revoked, I will not be eligible for any refund of the fees assessed for said permit. I also understand that, in addition to revocation of my permit, violation of any of the provisions, requirements, or conditions of this permit mandated by the City of Wichita may result in legal action taken against me.
I certify that I have not had a license revoked or suspended by the Kansas Department of Agriculture or a City breeder’s license or animal maintenance permit revoked within the last 18 months. Furthermore, I certify that I have not violated any applicable city, state or federal regulations pertaining to the care and control of animals and maintenance of my property.
Signature of OwnerDate
FOR OFFICIAL USE ONLY
ANIMAL CONTROL ID#: |
APPROVED |
NOT APPROVED |
DATE: |
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License Number: |
Date: |
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Expiration Date: |
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