PERMIT APPLICATION CONDITIONAL/PROHIBITED/NONNATIVE SPECIES FLORIDA FISH AND WILDLIFE CONSERVATION COMMISSION Division of Habitat and Species Conservation, Exotic Species Coordination Section 620 S. Meridian St., Tallahassee, FL 32399-1600 (Please Print or Type) NAME: ORGANIZATION/AGENCY/BUSINESS NAME: PHYSICAL ADDRESS (for FWC inspection) MAILING ADDRESS: PHONE NUMBER: FAX: ALTERNATE PHONE NUMBER: E-MAIL ADDRESS: I authorize FWC to send me requests for additional information and final agency permitting actions by either e-mail or express delivery. Future agency actions will be provided henceforth by email or express delivery. Add my email to the License and Permits Listserv so that I can receive email updates regarding licenses, rules changes, etc. Have you ever been convicted or found guilty, of any criminal or non-criminal violation, regardless of adjudication or plea entered, of any wildlife violation (including a violation of Chapter 379, F.S.; Section 828.12, F.S.; rules of the Commission; similar laws or rules in another jurisdiction) or crime involving cruelty to animals? YES NO If yes, please explain and list the type of violation(s) cited and the county/state where the violation occurred: Have you ever had a fish or wildlife-related permit suspended or revoked? YES NO Explain, if yes: Applicant Signature: Certification: I hereby swear and affirm by signature that the information submitted in this application and supporting documents is complete and accurate to the best of my knowledge and belief. I understand that any false statement herein may subject me to criminal penalties. I further state that I will abide by all applicable State, Federal, and local laws. Finally, I understand and agree to comply with the State laws and rules governing nonnative species and agree to comply with same. I also agree to comply with the data reporting requirements for this permit. PAGE 1 OF 6
Section 1. Purpose of application (check all that apply) For Commercial Dealers Import/possess conditional species for direct retail sale (not for fish farming) List Resident Fish Dealer s License # or Class III Exhibition and Sale License # or Aquaculture Certificate # If application is for conditional snakes and lizards, attach Part A of Critical Incident-Disaster Plan (FWCDLE 619) Complete Section 2A &2C (If application is for conditional snakes and lizards complete 2B & 2C) Collect/possess live conditional species from the wild (including FWC managed areas) List Commercial Fishing License # or Class III Exhibition and Sale License # List all FWC managed lands to be collected from List collection gear to be used If application is for conditional snakes and lizards, attach Part A of Critical Incident-Disaster Plan (FWCDLE 619) Complete Section 2A & 2C (if application is for conditional snakes and lizards, complete 2B & 2C) For Public Exhibitors Import/possess conditional species for public exhibition List Class III Exhibition and Sale License # If application is for conditional snakes and lizards, attach Part A of Critical Incident-Disaster Plan (FWCDLE 619) Complete Section 2A & 2C (if application is for conditional snakes or lizards, complete 2B & 2C) Import/possess prohibited species for public exhibition List Class III Exhibition and Sale License # Complete Section 2A and 2C Complete and submit Part A and a copy of Part B of Critical Incident-Disaster Plan (FWCDLE 619) Collect conditional or prohibited species from the wild and possess for public exhibition List Commercial Fishing License #, Class III Exhibition and Sale License # or Saltwater Products License # List all FWC managed lands to be collected from List collection gear to be used If application is for conditional species, complete Section 2A & 2C If application is for conditional snakes or lizards, complete Section 2B & 2C and attach Part A of Critical Incident-Disaster Plan (FWCDLE 619) If application is for prohibited species, complete Section 2A & 2C and attach Part A and a copy of Part B of Critical Incident-Disaster Plan (FWCDLE 619) For Researchers Import/possess conditional species Attach research proposal If application is for conditional snakes and lizards, attach Part A Critical Incident-Disaster Plan (FWCDLE 619) Complete Section 2A & 2C (if application is for conditional snakes or lizards, complete 2B & 2C) PAGE 2 OF 6
Import/possess prohibited species Attach research proposal and list of personnel with access to prohibited species Complete Section 2A and 2C Attach Part A and a copy of Part B of Critical Incident-Disaster Plan (FWCDLE 619) Collect and possess live conditional or prohibited species from the wild (including from FWC managed areas) Attach research proposal List all FWC managed lands to be collected from List collection gear to be used If application is for conditional species, complete Section 2A & 2C If application is for conditional snakes and lizards, complete Section 2B & 2C and attach Part A of Critical Incident-Disaster Plan (FWCDLE 619) If application is for prohibited species, complete Section 2A & 2C and attach Part A and a copy of Part B of Critical Incident-Disaster Plan (FWCDLE 619) Release nonnative, conditional or prohibited species Attach research proposal For Private Citizens Possess red-eared sliders for permanent personal possession Complete Section 2D Possess red-eared sliders temporarily for out-of-state relocation List destination Complete Section 2A & 2C Import leopard, African spurred, or Bell s hingeback tortoises List destination (ship to address or Expo name and location) and date of arrival (application must be received at least 10 days before shipment arrives) Attach veterinary health certificate certifying that all specimens have been examined for ectoparasites Import nonnative fish, including tropical fish, not listed as conditional or prohibited For Nuisance Wildlife Trappers and Python Permit Applicants Transport/possess live conditional reptiles Complete Section 2C Section 2. Biosecurity Information A. Facility description Describe the facility where specimens will be held. Include in your description information on drains, windows, doors, equipment, etc. Include the name and location of, and distance to the nearest water body for applications involving possession of aquatic species. Your facility must meet the standards set forth in Rule 68-5.001 for possessing conditional or prohibited species (see Section 4, page 6 for the standards). Attach additional sheets as necessary. PAGE 3 OF 6
B. Facilities for conditional snakes and lizards Describe the facility where conditional snakes and lizards will be held. Your facility must meet the standards set forth in Rule 68-5.001 (see Section 4, page 6 for the standards). Attach additional sheets as necessary. C. Transport methods If specimens are to be transported alive for import/export or for live transport after being captured, describe the transport containers and methods that will be used. Please note if imported specimens will not be removed from their original shipping boxes. Conditional snake and lizard species must double bagged using closely woven, double-seam sewn, cloth sacks, then placed in a secure container labeled Dangerous Reptiles. Nuisance trappers and python permit applicants: list areas of Florida where live conditional reptiles will be transported. D. Facility description for red-eared sliders Attach a description of how red-eared sliders will be permanently housed. Outdoor facilities for red-eared sliders must have a permanent containment barrier secured at least six inches below ground level to prevent escape by digging, erosion, climbing or by passing through gaps. Such barriers may be constructed of solid metal or weather-resistant and rot-resistant material, and may not use mesh material. All eggs must be removed and destroyed daily from outdoor facilities. PAGE 4 OF 6
Section 3. Species this application is for (attach extra sheets if needed) See http://myfwc.com/wildlifehabitats/nonnative_ruleregs.htm for lists of conditional and prohibited species. Quantity Common Name Scientific Name PAGE 5 OF 6
Section 4. Standards for possessing conditional and prohibited species Conditional freshwater fish and aquatic invertebrate species a. Held outdoors may only be held in a water body that has the lowest point of the top edge of its levee, dike, bank, or tank at an elevation of at least one foot above the 100-year flood elevation determined by reference to elevation maps issued by the National Flood Insurance Program, U.S. Department of Homeland Security. Such water body shall have no water discharge or shall be constructed with a barrier system designed to prevent escape of adults, juveniles, and eggs in the water effluent discharged from the permittee s property. Public visitation at facilities in possession of conditional non-native species shall occur only under supervision of the permittee or his/her designee. b. Held indoors may only be held in systems having no water discharge, having a water discharge through a closed drain system, or other system designed to prevent discharge of water containing adults, juveniles and eggs from the permittee s property. Conditional snake and lizard species May only be held in safe, secure and proper housing in cases, cages, pits or enclosures of the following specifications: a. Cage may be constructed of a variety of materials including: plate glass of at least one-quarter inch thickness, break-resistant plastic of similar strength, concrete reinforced with wire, sheet metal, molded fiberglass, plywood or interlocking lumber that has been treated to be impervious to moisture and is not less than one-half inch in thickness, or other materials which provide equivalent stability and security against escape and unauthorized intrusion. Cages and doors to cages shall be sealed. The doors of each cage shall be securely locked by a device operated by a key, combination lock, key card or other locking device approved by the Commission to prevent unauthorized intrusion. b. A room or out-building may contain conditional snake and lizard species in cages that are not locked provided that such a room or out building is locked by a device operated by a key, combination lock, key card or other locking device approved by the Commission to prevent unauthorized intrusion, is inaccessible to unauthorized personnel, is constructed and maintained as to be escape-proof, and has been inspected and approved as conforming to these rules by Commission personnel prior to use. Any out building so used must be of strong construction with concrete or other suitable flooring and securely anchored to the ground. Such building shall be clearly posted at point of entry with a sign stating Danger Dangerous Reptiles. c. Facilities with one or more permittee at the same facility location may not commingle their respective live conditional species inventories. All cages or enclosures must be clearly identified or visibly marked with the name of the permittee or other identifier to facilitate inventory inspections. d. All individuals associated with a facility authorized to possess conditional snake and lizard species shall demonstrate knowledge of facility requirements, and secure handling protocols for conditional snakes and lizards as established by the permittee. Prohibited aquatic species Shall be maintained in indoor facilities in containers or other confinement facilities designed to prevent escape and having no exterior water discharge or having a water discharge through a closed drain system that terminates in a dry-bed wastewater retention area with no public access. Prohibited terrestrial species Shall be maintained in indoor facilities in cages or other confinement facilities that prevent escape and public contact. Return completed application and all required materials to: FWC Exotic Species Coordination Section 620 S. Meridian St., Tallahassee, FL 32399 Or FAX to: 850-413-0381 Or Email to: nonnativepermitapps@myfwc.com For questions contact Jenny Tinnell at 850-926-0128 PAGE 6 OF 6