\nNotice of Objection To The Issuing Or Extension Of A Licence To Carry Out An Activity<\/legend>\r\n\r\n

\n\n\n\n\n\n

Form 4
\n-
\nNotice of Objection To The Issuing Or Extention Of A Licence To Carry Out An Activity Described By Section 192D of the Public Health Act\n<\/div>\n

\r\n 1- Name of Applicant\r\n *<\/span>\r\n <\/label>\r\n \r\n \r\n \r\n<\/div>\n

\r\n 2- Applicant\u2019s Business Address\r\n *<\/span>\r\n <\/label>\r\n \r\n \r\n \r\n<\/div>\n

\r\n 3- Licence Applicant Applied for\r\n *<\/span>\r\n <\/label>\r\n

<\/textarea>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_158_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container\">\r\n    <label for=\"field_xdnrj\" class=\"frm_primary_label\">4- Date of Application\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_xdnrj\" name=\"item_meta[158]\" value=\"\"  maxlength=\"10\" placeholder=\"DD\/MM\/YYYY\" data-reqmsg=\"4- Date of Application cannot be blank.\" aria-required=\"true\" data-invmsg=\"4- Date of Application is invalid\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_159_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container\">\r\n    <label for=\"field_knmgj\" class=\"frm_primary_label\">5- Name of Objector\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_knmgj\" name=\"item_meta[159]\" value=\"\"  data-reqmsg=\"5- Name of Objector cannot be blank.\" aria-required=\"true\" data-invmsg=\"5- Name of Objector is invalid\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_160_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container\">\r\n    <label for=\"field_35ctk\" class=\"frm_primary_label\">6- Business Address of Objector\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_35ctk\" name=\"item_meta[160]\" value=\", , , , , \"  data-frmval=\"{"line1":"","line2":"","city":"","state":"","zip":"","country":""}\" data-reqmsg=\"6- Business Address of Objector cannot be blank.\" aria-required=\"true\" data-invmsg=\"6- Business Address of Objector is invalid\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_161_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container\">\r\n    <label for=\"field_ipswa\" class=\"frm_primary_label\">7- Please  state  below  the  nature  of  your  objections.    Full  reasons  in  support  of  your  objections  should  also  be  given.    Any  documentary  evidence  submitted  to  the  Government  with  this  Notice should be in its original form, and shall be returned on  request.\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <textarea name=\"item_meta[161]\" id=\"field_ipswa\" rows=\"5\"  data-reqmsg=\"7- Please  state  below  the  nature  of  your  objections.    Full  reasons  in  support  of  your  objections  should  also  be  given.    Any  documentary  evidence  submitted  to  the  Government  with  this  Notice should be in its original form, and shall be returned on  request. cannot be blank.\" aria-required=\"true\" data-invmsg=\"7- Please  state  below  the  nature  of  your  objections.    Full  reasons  in  support  of  your  objections  should  also  be  given.    Any  documentary  evidence  submitted  to  the  Government  with  this  Notice should be in its original form, and shall be returned on  request. is invalid\" aria-invalid=\"false\"  ><\/textarea>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_162_container\" class=\"frm_form_field form-field  frm_top_container\">\r\n    <label for=\"field_8tnva\" class=\"frm_primary_label\">File Upload\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_8tnva\" name=\"item_meta[162]\" value=\"\"  data-invmsg=\"File Upload is invalid\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_442_container\" class=\"frm_form_field frm_section_heading form-field frm_top_container\">\n<h3 class=\"frm_pos_ frm_primary_label[collapse_class]\">Additional information<\/h3>\n\n\n<\/div>\n<div id=\"frm_field_409_container\" class=\"frm_form_field form-field  frm_top_container\">\r\n    <label for=\"field_sc67f\" class=\"frm_primary_label\">Email Address\r\n        <span class=\"frm_required\"><\/span>\r\n    <\/label>\r\n    <input type=\"email\" id=\"field_sc67f\" name=\"item_meta[409]\" value=\"\"  data-invmsg=\"Email Address is invalid\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_443_container\" class=\"frm_form_field form-field  frm_top_container\">\n\t<label for=\"field_dvwfa\" id=\"field_dvwfa_label\" class=\"frm_primary_label\">End Section\n\t\t<span class=\"frm_required\" aria-hidden=\"true\"><\/span>\n\t<\/label>\n\t<input type=\"text\" id=\"field_dvwfa\" name=\"item_meta[443]\" value=\"\"  data-invmsg=\"End Section is invalid\" aria-invalid=\"false\"  \/>\n\t\n\t\n<\/div>\n<div id=\"frm_field_444_container\" class=\"frm_form_field  frm_html_container form-field\">Applicant will be required to sign application form prior to document being issued by the Agency.<\/div>\n<div id=\"frm_field_163_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container vertical_radio\">\r\n    <label  class=\"frm_primary_label\">I  certify  that  the  information  contained  in  this  Notice  is  true  to  the  best  of  my  knowledge and belief.\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <div class=\"frm_opt_container\">\t\t<div class=\"frm_checkbox\" id=\"frm_checkbox_163-0\">\t\t\t<label  for=\"field_45dzi-0\">\n\t\t\t<input type=\"checkbox\" name=\"item_meta[163][]\" id=\"field_45dzi-0\" value=\"Yes\"  data-reqmsg=\"I  certify  that  the  information  contained  in  this  Notice  is  true  to  the  best  of  my  knowledge and belief. cannot be blank.\" data-invmsg=\"I  certify  that  the  information  contained  in  this  Notice  is  true  to  the  best  of  my  knowledge and belief. is invalid\" aria-invalid=\"false\"   aria-required=\"true\"  \/> Yes<\/label><\/div>\n<\/div>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_551_container\" class=\"frm_form_field  frm_html_container form-field\">* obligatory fields<\/div>\n\t<input type=\"hidden\" name=\"item_key\" value=\"\" \/>\n\t<div class=\"frm_submit\">\r\n\r\n<button class=\"frm_button_submit\" type=\"submit\"  >Submit<\/button>\r\n\r\n<\/div><\/div>\n<\/fieldset>\n<\/div>\n\n<\/form>\n<\/div>\n\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":11,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-2575","page","type-page","status-publish","hentry"],"rttpg_featured_image_url":null,"rttpg_author":{"display_name":"Chris Segovia","author_link":"https:\/\/www.environmental-agency.gi\/author\/csegovia\/"},"rttpg_comment":0,"rttpg_category":null,"rttpg_excerpt":null,"_links":{"self":[{"href":"https:\/\/www.environmental-agency.gi\/wp-json\/wp\/v2\/pages\/2575","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.environmental-agency.gi\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.environmental-agency.gi\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.environmental-agency.gi\/wp-json\/wp\/v2\/users\/11"}],"replies":[{"embeddable":true,"href":"https:\/\/www.environmental-agency.gi\/wp-json\/wp\/v2\/comments?post=2575"}],"version-history":[{"count":1,"href":"https:\/\/www.environmental-agency.gi\/wp-json\/wp\/v2\/pages\/2575\/revisions"}],"predecessor-version":[{"id":2576,"href":"https:\/\/www.environmental-agency.gi\/wp-json\/wp\/v2\/pages\/2575\/revisions\/2576"}],"wp:attachment":[{"href":"https:\/\/www.environmental-agency.gi\/wp-json\/wp\/v2\/media?parent=2575"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}