APPENDIX E: CIRCUS/ANIMAL PERFORMANCE EXHIBITION PERMIT FORM

 

CIRCUS/ANIMAL PERFORMANCE EXHIBITION PERMIT   PERMIT NUMBER __________     NAME OF CIRCUS/EXHIBITOR ___________________________________________________ ADDRESS _______________________________________________________________________ CITY ____________________________________ STATE ____________ ZIP ____________ TELEPHONE NUMBER ___________________________________________________________     LOCATION OF EXHIBITION: _____________________________________________________ PURPOSE _______________________________________________________________________ DATES: ____________________________________________ HOURS ___________________     PROOF OF INSURANCE ________________ YES ______________ NO ______________ FEE PAID _____________________________ FEE WAIVED __________________________     THIS APPLICATION IS: APPROVED _________________ DENIED ________________     SIGNED ____________________________

 

(Prior Code, Ch. 71)