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• 3 . Location where animals(s) kept (If rural route include road name) : 012 <br /> Street/Road <br /> City: I . <br /> A. Describe the method, materials, and square footage of facilities for <br /> confinement of the animal(s) : <br /> B. Is the animal(s) ever transported away from location where kept and <br /> returned? Yes . No <br /> C. Descri a transport vehicle or means and the special transport equip- <br /> ment u ed: <br /> 4. Species of animal (such as Feline) : <br /> A. Sub-type of species (such as Bobcat) : <br /> B. Number of this type animal kept: . <br /> C. General description of this type animal(s) kept: <br /> D. Where kid animal(s) come from prior to your ownership of? <br /> Name of prior person(s) who owned animal(s) <br /> Street/Road <br /> City . . <br /> County .. .� <br /> State — _____ <br /> E. How long have you kept the animal(s) in Orange County? <br /> Return this form to either office of the Orange County Health Department Not <br /> later than March 28, 1983, <br /> Owners not registering wild animals they keep by March 28 may be subject to a <br /> penalty of $50 per day per animal. <br /> 0l'ANGE COUNTY HEALTH DEPARTMENT <br /> 300 W. Tryon Sprees Suite 225 <br /> Hillsborough, 'C 27278 Carr Mill Mall <br /> 100 N. Greensboro Street <br /> - Carrboro, NC 27510 <br /> Telephone: Hillsborough 732-8181 , Ext, 305 Telephone : 942-4168 <br /> Durtam 688-7333 <br /> Chapel Hill 967-9251 <br /> Mebane 227-2032 <br /> 5. Signature of person submitting this registration: <br /> 6. Date this (registration filled out: <br />