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Animal Facility Permit Application

  1. Applicant Information

  2. Business

  3. Emergency Contact

  4. Has your organization ever been convicted of an animal related offense?

  5. Please read the following requirements carefully and check each to show you have read and understand the below.*

  6. Disclaimer and Signature

    I certify that my answers are true and complete to the best of my knowledge. I have received a copy of the Norfolk City Code 6.1-63 (Report of animal or human exposure) and agree to comply with the applicable provisions. I understand that my permit may be denied or revoked at the discretion of the Animal Control Officer at any time for any violation of local, state or any Federal laws relating to animals. I understand that inspections shall be completed annually.

  7. Permit shall be valid through December 31 of the year of issue and shall be renewed by January 31 of each subsequent year.

  8. Leave This Blank:

  9. This field is not part of the form submission.