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APPENDIX C: PET SHOP/BREEDER PERMIT FORM
 
PET SHOP/BREEDER’S PERMIT
 
 
NO. ____________
 
 
FEE: $50.00
 
 
APPLICANT’S NAME ________________________________________________________
 
ADDRESS ___________________________________________________________________
 
PHONE NUMBER ____________________________________________________________
 
 
Applicant must adhere to all rules and regulations contained in the Town of Bremen Ordinance 10-92.
 
 
Date ________________________
 
 
________________________________ ________________________________
Applicant’s Signature               Clerk-Treasurer Approval
 
(Prior Code, Ch. 71)
APPENDIX D: DANGEROUS ANIMAL/ATTACK DOG PERMIT FORM
 
TOWN OF BREMEN, INDIANA
DANGEROUS ANIMAL/ATTACK DOGS PERMIT
 
 
   PERMIT No. ____________
 
Applicant’s Name: _____________________________________________
 
Address: _____________________________________ Phone: ______________________
 
Type of Dangerous Animal/Attack Dog(s)
________________________________________________________________
 
Number of Animals ____________
 
 
   Fee $50.00 per animal: _______________
 
 
Photograph Submitted:            ______________________________
 
Proof of Liability Insurance:         ______________________________
(minimum $300,000)
 
Town of Bremen Registration Tag:      ______________________________
 
 
Applicant Signature ___________________________________________ Date _________
 
 
Approved by:                        ______________________________
                              Clerk-Treasurer
 
(Prior Code, Ch. 71)
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)