7/31/2019 Private Shooting Preserve Permit Renewal
Application
1/1
FEE $63.00Make Check Payable to DEEP
Wildlife Division
79 Elm StreetHartford, CT 06106
REGULATED PRIVATE SHOOTING PRESERVE PERMIT RENEWAL
Connecticut General Statutes Section 26-48 and regulations
26-48-(1-11)
1. Name of Preserve______________________________________
2. The preserve will be located in the following town (s):
3. Acreage to be included in permit: OwnedLeased or under an
Agreement
Total
Note: All permittees with leases or agreements on file with DEEP
which are more than five years old willneed to submit updated
copies and appropriate maps upon renewal.
4. Preserve will be operated as:
Private Preserve (owner and guests only) Club Preserve (members
and guests only) Commercial Preserve (hunting permitted by payment
of fee)
5. Are the boundaries the same as last year? Yes NoIf the answer
is NO, enclose a map showing changes. For any change in acreage of
land not ownedby the permittee, a copy of the lease or agreement of
hunting rights must accompany application.
6. Will game be raised on the property for liberation? Yes NoIf
yes, a Game Breeders (GB) license is required. What is your GB
license #?__________
7. Will game be purchased for liberation on this property? Yes
No
If yes, from
whom?______________________________________________________
8. Type of game to be included in permit:Pheasants Quail Chukar
Partridge Ducks Other ________
9. Will shooting be done on Sunday under this permit? Yes No(if
the answer is yes, a statement signed by the proper town
authorities that Sunday shooting will be permitted,MUST be filed
with the Commissioner. After a statement has been filed once, it
will be considered to remain in forceuntil canceled by the proper
town authorities.)
10. I would like to order tags @ .20 cents per tag. Note: A
check for $63.00 (permit
fee) plus $ _______ fee for tags must accompany this
application.
11. I have read the laws and regulations pertaining to private
shooting preserves and amfamiliar with their provisions. Yes No
Name: Signed:(Please Print)
Acting for Club: Address:
Telephone Number: Email Address:
Rev. 7/12/2011 Date of Application: _____________
