7/31/2019 Regulated Hunting Dog Training Area Permit Renewal Application

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Fee: $18.00Make Check Payable to DEEP

Wildlife Division

79 Elm Street

Hartford, CT 06106

RENEWAL APPLICATION -- REGULATED HUNTING DOG TRAINING AREA PERMITApplication is hereby made for a permit under authority of Sec. 26-49 of the 1971 Supplement to theGeneral Statutes to establish a Regulated Hunting Dog Training Area.

_____________(Date)

1. I, _________________________________________ am the holder of Regulated Hunting Dog(Name of Club or Individual)

Training Area Permit #_________issued for the period of July 1, 20_ _ to June 30, 20 _ .

2. The area where birds are to be shot in connection with dog training will consist of _____ acres located

in the town of ________________________, CT and owned by ____________________________.

Note:If a new area is being used for this purpose which is not under the ownership of the permittee, a statement from

the owner must accompany this application stating that the permittee has permission to use the area for the purpose of

dog training and the shooting of birds in connection therewith. A Department inspection will also be required.

3. I am the holder of (one of the following is required):

Private Shooting Preserve Permit #_________ expiring on March 31, 20____.

Game Breeders License #__________ for the year 20____.

Commercial Kennel License #____________ for the year 20____.

4. Shooting will be done on Sunday _________ Yes ________ No

NOTE: If permission to shoot on Sundays has not previously been obtained from the proper town officials, a

statement granting this permission must accompany this application.

5. Regulated Hunting Dog Training Area will be operated as:

Private (Permittee and guests only)

Club (Members and guests only)

Commercial (Open to the public)

6. Enclosed is the $18.00 permit fee plus $_________ for ________ tags @ $.20 each to be used

for the tagging of quail,chukar orpheasant to be liberated on the area where birds may be shot.

Name: Signed:(Please Print)

Acting for Club: Address:

Telephone Number: Email Address:

PleaseNOTE:Applications will be returned due to failure to report previous years activities, incompleteapplications or incorrect fees.

Rev 7/12/2011