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3. Name (Last, First, M.I.):*
5. Address*
7. City*
8. State*
9. Zip*
11. Home Phone*
12. Cell Phone
14. Email*
15. Do you own your residence?*

    1. Yes

    1. No
17. Have you taken a beekeeping course?*

    1. Yes
    2. No
18. If yes, please provide certificate.
20. Please provide an overall view of your property with indication on where you plan to have the bee coop located.*
24. Read and initial each item, then sign and date below.
26. If required to do so, I have provided written permission from the property owner of the residential lot on which I will be keeping the bee hives.*
    (First-time applicants only. See Fredericksburg City Code § 14-240.)
28. I understand and agree to abide by all of the conditions under which I will be allowed to keep honeybees, which are as follows:*
    1. 1. No more than two hives may be kept on any residential lot.
    2. 2. Hives must be located at least ten feet from any side property line or public sidewalk and five feet from any rear property line.
    3. 3. A constant supply of fresh water shall be provided on the lot, within twenty feet of all hives.
    4. 4. A flyway barrier at least six feet in height, consisting of a wall, solid fence, or dense vegetation, shall shield any part of a property line that is within twenty-five feet of a hive, or facing a hive opening.
30. I understand that the City may revoke my permit for a violation of any applicable law or regulation regulating the keeping of bees. I must correct any violations as soon as possible.*
32. Applicant Signature: I understand that checking the box below is the equivalent of signing my name.*

    1. I Accept
34. Applicant Name*
35. Date*
    Date
37. Permits must be renewed by January 1 each year. Failure to do so will cause you to incur late fees and/or be cited by Animal Control/Police Officers for failure to obtain a permit.
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40. 1. Receive an email copy of this form.
41. Email address

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