Form FDACS-09119 "Request for Inspection/Application for Permit to Feed Garbage to Swine" - Florida

What Is Form FDACS-09119?

This is a legal form that was released by the Florida Department of Agriculture and Consumer Services - a government authority operating within Florida. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on May 1, 2013;
  • The latest edition provided by the Florida Department of Agriculture and Consumer Services;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form FDACS-09119 by clicking the link below or browse more documents and templates provided by the Florida Department of Agriculture and Consumer Services.

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Download Form FDACS-09119 "Request for Inspection/Application for Permit to Feed Garbage to Swine" - Florida

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Florida Department of Agriculture and Consumer Services
Remit $50.00 Non-Refundable
Application Fee Online at:
Division of Animal Industry
www.FDACS.gov/ai
Bureau of Animal Disease Control
- or -
Check or Money Order Payable
REQUEST FOR INSPECTION/APPLICATION FOR
to FDACS and remit to:
NICOLE "NIKKI" FRIED
FDACS
PERMIT TO FEED GARBAGE TO SWINE
COMMISSIONER
P.O. Box 6710
Tallahassee, FL 32314-6710
585.51, Florida Statutes
5C-11, Florida Administrative Code
Contact: Swine Programs Office
407 S. Calhoun Street
Tallahassee, FL 32399-0800
850-410-0900 Fax: 850-410-0946
www.FDACS.gov/ai
Note: All documents and attachments submitted with this request are subject to public review pursuant to Chapter 119, F.S.
COMPLETE ALL ITEMS
APPLICANT INFORMATION (Please Print):
Owner Name
Email
Mailing Address
City
Zip Code
Facility Address
City
Zip Code
Telephone No.
County
GPS
Longitude (5 digit decimal)
Latitude (5 digit decimal)
This is a written request to the Florida Department of Agriculture and Consumer Services to inspect my swine facilities and equipment for the express
purpose of approving such as a permitted garbage feeding premises.
I understand that to initiate the approval process, the non-refundable applicant fee is to be made in the form of a cashier’s check or money order in the
amount of $50.00 made payable to FDACS and mailed to:
Florida Department of Agriculture and Consumer Services
Post Office Box 6710
Tallahassee, Florida 32314-6710
(Signature of Applicant)
(Date)
INFORMATION: After receipt of this Request for Inspection/Application for Permit to Feed Garbage to Swine by the Department, with attached
remittance of required inspection fee, a Department representative will arrange for initial inspection of your facility. Inspection will be recorded on the
Application for Permit to Feed Garbage to Swine (FDACS Form 09015), signed by facility owner and Department inspector, and returned with
appropriate Annual Permit/Renewal Fee according to the following schedule: $50 (1-25 Swine), $100 (26-50 Swine), $150 (51-100 Swine), or $200
(over 100 Swine).
For Office Use Only
ORG CODE: 42 09 02 01 000-
EO: A2
OBJECT CODE: 001359
Fee: $50.00
Received: _______________________
Distribution: Original (Return with Fee) Copy (Owner)
FDACS-09119 Rev. 05/13
Florida Department of Agriculture and Consumer Services
Remit $50.00 Non-Refundable
Application Fee Online at:
Division of Animal Industry
www.FDACS.gov/ai
Bureau of Animal Disease Control
- or -
Check or Money Order Payable
REQUEST FOR INSPECTION/APPLICATION FOR
to FDACS and remit to:
NICOLE "NIKKI" FRIED
FDACS
PERMIT TO FEED GARBAGE TO SWINE
COMMISSIONER
P.O. Box 6710
Tallahassee, FL 32314-6710
585.51, Florida Statutes
5C-11, Florida Administrative Code
Contact: Swine Programs Office
407 S. Calhoun Street
Tallahassee, FL 32399-0800
850-410-0900 Fax: 850-410-0946
www.FDACS.gov/ai
Note: All documents and attachments submitted with this request are subject to public review pursuant to Chapter 119, F.S.
COMPLETE ALL ITEMS
APPLICANT INFORMATION (Please Print):
Owner Name
Email
Mailing Address
City
Zip Code
Facility Address
City
Zip Code
Telephone No.
County
GPS
Longitude (5 digit decimal)
Latitude (5 digit decimal)
This is a written request to the Florida Department of Agriculture and Consumer Services to inspect my swine facilities and equipment for the express
purpose of approving such as a permitted garbage feeding premises.
I understand that to initiate the approval process, the non-refundable applicant fee is to be made in the form of a cashier’s check or money order in the
amount of $50.00 made payable to FDACS and mailed to:
Florida Department of Agriculture and Consumer Services
Post Office Box 6710
Tallahassee, Florida 32314-6710
(Signature of Applicant)
(Date)
INFORMATION: After receipt of this Request for Inspection/Application for Permit to Feed Garbage to Swine by the Department, with attached
remittance of required inspection fee, a Department representative will arrange for initial inspection of your facility. Inspection will be recorded on the
Application for Permit to Feed Garbage to Swine (FDACS Form 09015), signed by facility owner and Department inspector, and returned with
appropriate Annual Permit/Renewal Fee according to the following schedule: $50 (1-25 Swine), $100 (26-50 Swine), $150 (51-100 Swine), or $200
(over 100 Swine).
For Office Use Only
ORG CODE: 42 09 02 01 000-
EO: A2
OBJECT CODE: 001359
Fee: $50.00
Received: _______________________
Distribution: Original (Return with Fee) Copy (Owner)
FDACS-09119 Rev. 05/13