III. PERMITS
Attach proof of state and/or federal permits for the species or specimen when so required
by law to this application.
List permits attached:
1. ________________________________________________________________________
2. ________________________________________________________________________
3. ________________________________________________________________________
4. ________________________________________________________________________
IV. LIABILITY INSURANCE
I have the following insurance protection (check one):
A security bond in the amount of at least $100,000.00 issued by:
(A copy of the security bond is attached to this application.)
________________________________ ____________________
Name of Surety Date of Bond
Liability insurance (such as homeowner’s insurance). (A letter from an
insurance agent stating the policy covers wild animal incidents up to $100,000.00,
or a copy of insurance policy stating the same is attached to this application.)
________________________________ ____________________
Name of Insurance Company Policy Number
________________________________ ____________________
Name of Insured Date of Policy
I understand that no cancellation of the insurance or bond will be made unless thirty (30) days
written notice is first given to the animal control officer. __________ (Initial)
V. SIGNATURE
I understand that this permit may be revoked for any violation of the City of Helena Ordinances
and that providing false information on this document may be punishable under Section 45-7-
203, MCA.
_______________________________________ ________________________________
Signature of Applicant Date
For Official Use Only
APPROVED DENIED
Property inspected by Animal Control Officer (ACO) ______________________________ on _______________
Name Date
Application reviewed by City Attorney: ______________________________ on _______________
Signature Date
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