Chicken Permit Application

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.
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.
Your Information
Name*

First NameMiddle NameLast Name
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Alternate Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Zoning Type of this Address*
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Email*
example@example.com
Date of Birth*

MonthDayYear
We require this for background checks.

Chicken Information
Establish New Chicken FlockRenewal Application - NO CHANGES in FlockRenewal Application - CHANGES in Flock

Describe Chickens (Limit of 6 chickens per single-family dwelling.)*

Photo Submission

You are required to submit pictures of both the coop and pen with your application. Please let us know if you are going to come in-person to submit photos, otherwise you will be directed to upload them on this form.
YesNo

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. *

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Printed Name*

First NameLast Name
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Your Information