Fillable SOUTH BEND ANIMAL RESOURCE CENTER (City of South Bend)

Fill Online, Printable, Fillable, Blank SOUTH BEND ANIMAL RESOURCE CENTER (City of South Bend) Form

Use Fill to complete blank online CITY OF SOUTH BEND (IN) pdf forms for free. Once completed you can sign your fillable form or send for signing. All forms are printable and downloadable.

SOUTH BEND ANIMAL RESOURCE CENTER (City of South Bend)

On average this form takes 16 minutes to complete

The SOUTH BEND ANIMAL RESOURCE CENTER (City of South Bend) form is 2 pages long and contains:

  • 0 signatures
  • 51 check-boxes
  • 40 other fields

Country of origin: US
File type: PDF

U.S.A. forms for City of South Bend

BROWSE CITY OF SOUTH BEND (IN) FORMS

Related forms
Fill has a huge library of thousands of forms all set up to be filled in easily and signed.
Fill in your chosen form
Sign the form using our drawing tool
Send to someone else to fill in and sign.
find another form
 
SOUTH BEND ANIMAL RESOURCE CENTER
521 Eclipse Place, South Bend, IN 46628 Phone:
(574) 235-9303; Fax: (574) 235-7611
Email: sbarc@southbendin.gov
CHICKEN PERMIT APPLICATION
No roosters are allowed within city limits. There is a limit of 6 chickens per single-family dwelling. No
chickens are allowed for multi-family dwellings.
Your Information
Name: Phone Number:
Address: City: State: Zip:
Email: Alternate Phone Number:
Chicken Information
Location/Address:
Zoning Type of this Address: SF1 SF2 MF1 MF2 OB MU O LB CB CBD GB
Not sure of zoning? Look it up here: https://www.sjcindiana.com/996/Zoning-Map
Describe Chickens:
Limit of 6 chickens per single-family dwelling.
Reason for Application
Establish New Chicken Flock
Renewal Application – NO CHANGES in Flock
Renewal Application – CHANGES in Flock
Chicken Coop Checklist
Sides are Solid
Roof is Solid
Doors are Solid
Doors Shut Securely
Doors Lock
Vents Provided
Vents Covered w/Wire
Impermeable to Rodents
& Predators
At least 18” High
At Least 1sqft per Chicken
Total Square Feet ____________
Rev. 7.30.19 mmj
Breed
Age
Continued Next Page
Click to Clear Form
CHICKEN PERMIT APPLICATION CONTINUED
Chicken Pen Checklist
Impermeable to Predators
At Least 2sqft per Chicken
Fence Height 6ft or Less
Pen Covered with Wire / Aviary Net / Solid Roof
Total Square Feet ____________
Coop & Pen Location Checklist
Behind Residential Structure
Coop Located 15ft or more from Any Property Line → Distance in feet ______________
Coop Located 20ft or more from Any Residential Dwelling → Distance in feet ______________
Pictures Checklist
You are required to submit pictures of both the coop and pen with your application. Please submit photos by e-
mail to: sbarc@southbendin.gov or in person ~or~ request an Animal Welfare Officer personally inspect.
Coop – Left Side
Coop – Right Side
Coop – Back
Coop – Front
Coop – Roof
Coop – Door & Lock
Coop – Vent
Coop – Location in Pen
Pen – Left Side
Pen – Right Side
Pen – Back
Pen – Front
Pen – Roof
Pen – Location on Property Request an Animal Welfare Officer Inspection
Signature
I hereby make application to operate a chicken flock within the city limits of South Bend. I have not been convicted of
cruelty to animals and affirm the information I have given on this application is true and correct.
Printed Name Signature Date
Want to learn more about urban chicken regulations? Please see sections 5-20 “Urban Chicken Regulations” & 21-02.11(a) “Additional
Standards for Chickens, Chicken Coops, and Chicken Pens” of the Municipal Code found here:
https://library.municode.com/in/south_bend/codes/code_of_ordinances
Internal Use Only Date Received: _____________ Staff Member Who Processed: _____________________
Approve Deny More Information Needed
Staff Notes: _______________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
Once complete, e-mail as an attachment to: sbarc@southbendin.gov
Download
Save PDF to desktop
Email
Email completed PDF
Send for Signing
Email for others to sign
Print
Print document
Choose a Field
Click on a field and
select the person that should complete it
Want to add a signature?
You can add a signature field
and assign it to someone else
to sign
Choose a Field
Click on a field and
select the person that should complete it

SOUTH BEND ANIMAL RESOURCE CENTER (City of South Bend)

This document is locked as it has been sent for signing.

You have successfully completed this document.

Other parties need to complete fields in the document. You will recieve an email notification when the document has been completed by all parties.

This document has been signed by all parties.

Completed 16 July 2020

Message

View Audit Log
Print With Audit Log
Duplicate Document