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Home My WebLink AboutUrban chicken applicationCity of Iowa CityDivision of Animal Services410 E. Washington Street, Iowa City, Iowa 52240 (319) 356-5295Urban Chicken Permit Application Failure to complete all sections of the application and provide supporting documentation will result in a denial of your application. Applicant InformationName ______________________________________________________________________________________________________________________________________Address ___________________________________________________________________________________________________________________________________Home or Cell Phone _______________________________________________ Work Phone ______________________________________________________ **24-hour emergency contact phone number _____________________________________________________________________________________ This is the number that will be called if we receive a complaint about the chickens on your property.Number of chickens to be kept ________. No roosters are allowed, Max number of hens (4) Complete the following attachments: • Attachment A: Description of the chicken coop and pen, including materials used and cubic feet • Attachment B: Sketch identifying the property boundaries and indicating the location of coop and pen • Attachment C: For tenants only—Landlord Approval form. • Attachment D: Urban Chicken Adjacent Owner form (include separate sheet) Initial:_______1) I have read the Iowa City Urban Chicken Policy and understand the requirements for keeping chickens._______2) I am aware that owners of all adjacent properties (i.e., all properties that contact each other at any point) must _______ give their written consent for any urban chicken permit application to be approved._______3) I am aware that I first must receive approval from the City prior to obtaining chickens._______4) I will follow all City ordinances and state laws relating to the care and keeping of animals.._______5) I am aware that I am responsible for keeping chickens within the confines of my property at all times._______6) I am aware that I may not make any dimensional changes to my chicken coop without first obtaining approval _______ from Animal Services._______7) I grant the right for City staff to inspect my property prior to approval of this permit. I further grant the right for _______ City staff to inspect my property one year after the permit is granted and at any other time to investigate a _______ complaint._______8) I acknowledge that I live in a single-family dwelling as per zoning code._______9) I affirm that I have never been found guilty of any animal welfare, neglect or cruelty code._______10) I am aware that I may not add to the number of chickens listed on this application without first obtaining _______ approval from Animal Services._______11) I understand that the permit is a limited license for the activity and no vested zoning rights arise from the _______ permit being issued and that the permit does not run with the land. _______12) I understand the private restrictions on the use of the property shall remain enforceable and shall supersede _______ the permit. I affirm that there are no private restrictions including, but not limited to, deed restrictions, _______ condominium restrictions, neighborhood association bylaws, covenants, and restrictions and rental agreements. _______ A permit issued to a person whose property is subject to private restrictions that prohibit keeping of chickens is _______ void. I affirm that all statements contained in the application and Attachments A-D are true and correct and that I the permit holder will keep the chickens in compliance with all related ordinances and Urban Chicken Policy. I understand that failure to comply with regulations may result in revocation of the permit and/or issuance of a municipal infraction.Signature_____________________________________________________________________ Date______________________________ For City Use OnlyInitial Permit Application Fee: $100 Paid _________________ Receipt # ___________________________________________________Renewal Permit Fee: $75 Paid _________________ Receipt # ___________________________________________________Housing and Inspection Approval: Date _________________ Official ______________________________________________________Animal Control Inspection: Date _________________ Officer _______________________________________________________Applicant Meets Requirements _________ Does Not Meet _________ Corrections Needed _________Supervisor’s Review ____________________________________________________________________________________________________________Approval Date _____________________________ Denied __________________________________________________________________________Reason for denial _______________________________________________________________________________________________________________ ___________________________________________________________________________________________________________________________________Permit Number: ________________________________________________________________________________________________________________ Issue Date _________________________________________________ Expiration Date _________________________________________________Next Inspection Review Due ____________________________ Adjusted # of Chickens _________________________________________ City of Iowa CityDivision of Animal Services410 E. Washington Street, Iowa City, Iowa 52240 (319) 356-5295 City of Iowa CityDivision of Animal Services410 E. Washington Street, Iowa City, Iowa 52240 (319) 356-5295 ATTACHMENT A Describe the chicken coop and pen including materials used and cubic feet ATTACHMENT B Sketch a diagram below of the property including the dimensions and • Identify the adjacent properties by street address • Indicate the location of coop and pen ATTACHEMENT CTo be completed only if the applicant is a tenant.I am the owner/landlord of ___________________________, Iowa City, Iowa, and I give permission for my tenant, ___________________________________________, to install a chicken coop and keep chickens on the property. ____________________________________________ ___________________ Signature of Owner/Landlord Date City of Iowa CityDivision of Animal Services410 E. Washington Street, Iowa City, Iowa 52240 (319) 356-5295 ATTACHMENT D The City of Iowa City Resolution No. 12-533 adopting the Urban Chicken Policy requires that any person wanting to keep chick- ens shall first receive written approval from all property owners’ adjacent to the property where the proposed chickens are to be kept. Adjacent means all parcels of property that share a property line with the applicant’s property including properties that contact each other only at one point.Applicant Name: _________________________________________________________________________________________________________________________Site Address: __________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Attached is a diagram of where the coop and pen will be. I/We, being the adjacent property owner(s), have no objections to the above named person, keeping chickens in accordance with Iowa City Ordinances and the Urban Chicken Policy. Name Address Phone Date City Staff Verification _______________________ Date___________________________________________