Web Application - Specialty Animal Licence

Urban Hen Keeping Application Form

All of the following information is necessary to facilitate a processing your request. All materials submitted must be clear, legible and precise. Only complete requests can be processed.

Bold

or asterisk (*) fields are mandatory.

Last Name:

First Name:

Email Address:

Phone Number:

(

)

Postal Code:

As the applicant, I affirm (check one:)

I am the registered owner of the property.

I have permission of the registered owner to make an application. (Attach copy.)

Site Information:

Search for property:

Find By Address

Property

Number of Hens:

Description of Coop Location:

Coop Width (m):

Coop Depth (m):

I have read and agree to follow the City's Urban Hen Keeping procedures and guidelines. *

I have informed my neighbours, whose properties are immediately adjacent or attached to my property, that I will be applying for a urban hen coop to be located on my property. (Failure to inform neighbours that a coop will be located on your property may result in revocation of the license). Copy attached. *

If you have not yet downloaded and completed the Neighbour Letter, you can find it here

Add Notification Document

	Upload File Name	Description

I have a plan for how to manage organic waste from my hens. *

I agree to notify Animal Control on any changes in flock size, or if any hens are replaced. *

I have taken urban hen keeping training. *

Provide Information Below:

Session Location:

Session Date:

Session Instructor:

Add Training Certificate

	Upload File Name	Description

For the first year of the program, you must have the support and assistance from a recognized mentor. Please provide your mentor’s information below.

Mentor Name:

Mentor Experience:

Mentor Contact Information:

I agree to notify Animal Control of any disease or welfare issues that arise that may affect the public and the steps taken to rectify the situation. *

The Province of Alberta requires all owners of poultry (including small urban flocks) to register their flocks into the provincial database and obtain a Premise Identification (PID) Number.

Premises Identification Number:

A site plan is required to process your application. Please attach a site plan.

Add Site Plan

	Upload File Name	Description

Please attach drawings or photos that help describe where on their property the Coop will be placed. Please press the button for each item you wish to upload.

If you have any other information that would be helpful to process your request, please include it here. (Comments Box)

Add Supporting Documents

	Upload File Name	Description

I certify that the above statements are true and correct to the best of my knowledge. I understand that providing false statements may disqualify my application. *

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	This personal information is collected by the City under the authority of Section 33(c) of the Freedom of Information and Protection of Privacy Act (Alberta). It will be used for the operation of the Special Pet Licence Program by internal City departments and for bylaw enforcement purposes, and shared with outside organizations for the purpose of managing urban hen keeping. If you have any questions about this collection, contact the Director, Community Standards Peace Officer Section, at the Animal Care & Control Centre at 13550 163 St NW, Edmonton, AB T5V 0B2 or by phone at 780-495-0655. If you wish to provide feedback on the Online Special Animal Licence application, please send your comments to the email address: [email protected].