KENNEL PERMIT FOR JUDY BURTNER-HYDE DBA BURTNER KENNELS.PDF

- Maricopa County
Animal Care and Control
2500 South 27th Avenue
Phoenix, AZ 85009
(602) 506-7387 Tele.
(602) 506-2739 Fax
K
KENNEL PERMIT 2p- O000 3°
APPLICATION
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Name: Kennel Name:
Address: 22° 22/2 7“ ~~ Kennel Address:_ “507 7 AFR Ge
Mailing
city: WAeve State: AZ Zip: (5S 3 city: Lacbex foe, Lip: SL FPS
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County Supervisorial District:
-Phone/£22 ML ee eg - Kennel Phone: Lb2 VEC eI P
Please complete and sign this application and return it to the above address with payment jin the amount of three
hundred fifty dollars ($350.00) within ten (10) days of receipt. .
NOTE: Failure to'renew the kennel permit by the. expiration date of the previous-year.kennel permit will result in
penalty fees-for each dog ‘being‘assessed at $6 per month for unaltered dog. and..$3 per month for altered dog in
addition to the permit fee. It is.suggested the renewal application be submitted 4 — 6 weeks in advance of the
expiration date to allow timely processing.
Pursuant to Arizona statute and county ordinance, a person must obtain a kennel permit issued by the Board
of Supervisors if the person operates a kennel in which there are five or more dogs which.are not individually
licensed. A.R.S. -§11-1009(A). A kennel is defined as “an enclosed, controlled area, inaccessible to other
animals, in which a person keeps, harbors or maintains five or more dogs under controlled conditions.” A.R.S.
,
§ 11-1007(8).
An _appointment-will be ‘scheduled for inspection of the kennel premises by an Animal Control Officer upon
receipt of this kennel permit application and ‘fee._This kennel application properly executed and a copy of the
inspection report will then be forwarded to, and must be approved by, the Maricopa County Board of
‘supervisors. The kennel permit form will be sent to you after approval and will be valid for one year from the
date of the Board’s approval.
NOTE: Failure to show fora scheduled inspection and/or failure of inspection will warrant a Subsequent
Inspection Return fee of $49 fcr each additional visit at time of inspection. Failure of inspection may result in
denial of the kennel permit anc:require individual licensing of each dog under;the provisions of A.R.S. §11- .
.
1008. f 2
PLEASE ANSWER THE FOLLOWING QUESTIONS AND INITIAL EACH RESPONSE
4. We assume complete responsibility for the kennel at the premises for which I/we are making
ajiplication for a permit and understand that “kennel’ means an enclosed, controlled area, inaccessible to

other animals, in which a person keeps, harbors or maintains five or more dogs under controlled
conditions (ARS 11-1001).
2. Qu We certify that I/We have YS dogs and that the kennel meets the definition in statute.
3. _C We certify that I/We have not been convicted of a violation of A.R.S. §§ 13-2910 (cruelty to animals)
or 13!2910.01 (dog fighting), or similar violations of any other state, county or municipal animal welfare law.
(Violations of license and leash laws DO NOT apply).
4, We certify that all dogs over the age of three (3) months that are kept, harbored or maintained on the
Chip
premises of the above named kennel have been properly vaccinated against rabies by a veterinarian licensed to
practice in the state of Arizona and that a current vaccination certificate signed by a licensed veterinarian is
maintained on the premises for each dog.
5. te We certify that We are submitting a valid copy of the rabies vaccination certificate for each
with this application.
We understand that a dog remaining within the kennel is not required to be. licensed individually under
cpl
A.R.S. § 11-1008. I/we also understand that a dog leaving the controlled kennel conditions shall be licensed .
under A.R.S. § 11-1008 except if the dog is only being transported to another kennel which has a permit issued
under this section.
We understand that a person who fails to obtain a kennel permit under A.R.S.§11-1009 is subject to a
a aa
pehalty of twenty-five dollars in addition to the annual fee.
a Qutb We understand that.a person who knowingly fails to obtain a kennel permit within thirty days after
writen notification from the county enforcement agent is guilty of a class 2 misdemeanor..
9. athe undersigned understand that that the kennel permit does not authorize the operation of any type
of blisiness and is solely used for the purpose of licensing multiple dogs.
I/We certify that all of the information I/We have provided is true and accurate under penalty of law.
Applicant Signature)
Applicant Signatur
For Official Use Only:
Copies of Valid Rabies Vaccination Certificates for each dog attached
Copy of Person's Valid Identificatior. Attached
Type of Identification submitted
BOS Approval Date. * Term of Permit
October 2015

Maricopa County Animal Care and Control
2500 S. 27th Avenue
Phoenix, AZ 85009-6797
(602) 506-7387
http://pets.maricopa.gov
Receipt Number: R20-381960 Receipt Date: 12/22/2020
Person ID: P1875830
Phone: 602 4862928
BURTNER KENNELS
42/22/2020 11:23:35Al na.
eS0G N NGETHAVE
BUCKEYE, AZ 85396
Item: Animal ID: Reference No: Price: Each: Amount:
KEN PERMIT A7777777 K21-000036 $350.00 1 $350.00
Total Fees Due: $350.00
Payments: Cash:
Check: $350.00
Credit Card:
Total Payments Received: $350.00
Would you like to share your experience with our service to you? Thank You!
Please visit our website at http://pets.maricopa.gov and click on I
5	1	18	1	9	11	1771	1692	123	25	59.309982	—
5	1	18	1	9	12	2146	1691	101	37	95.225319	$0.00
4	1	18	1	10	0	201	1698	1997	55	-1	
5	1	18	1	10	1	201	1713	98	32	96.469398	Want
5	1	18	1	10	2	310	1713	43	31	96.125870	To
5	1	18	1	10	3	367	1713	65	31	96.125870	and
5	1	18	1	10	4	448	1713	142	32	90.847588	Contact
5	1	18	1	10	5	604	1713	163	31	88.506020	MCACC
to email your comments for our . : ,
. Balance Due: $0.00
review.
Animal Information: NANA
A7777777 KENNEL PERM - BORN 9/14/1999, SPAYED, UNKNOWN/MIX, TRICOLOR DOG
License Information:
Tag Number: License Expires: Animal# Vacc Date: Vacc Expires:
Pet Licensed/Registered To: Burtner Kennels
Please retain this receipt with your pet's records
luffmanm WBUSOFF

Maricopa County
Animal Care & Control
2500 South 27"* Avenue
Phoenix, AZ 85009
Phone: (602) 506-7387
pets.maricopa.gov
KENNEL PERMIT K21-000036
PREMISE INSPECTION
Number of Dogs: 45
Name: JUDY BURTNER-HYDE Kennel Name: BURTNER KENNELS
Mailing Address: 1509 N 19474 AVE Kennel Address: Same
City: BUCKEYE State: AZ Zip: 85396 City: BUCKEYE Zip: 85396
County Supervisorial District: 4
Phone: 602-486-2928 Kennel Phone: 602-486-2929
1. Are all dogs over the age of three months properly vaccinated for rabies and in
possession of a valid rabies vaccination certificate?
YES
2. Is the kennel an enclosed, controlled area, inaccessible to other animals, in which a
person keeps, harbors or maintains five or more dogs under controlled conditions?
YES
NOTE: Copies of each rabies vaccination certificate must be attached to the Kennel Permit
Premise Inspection form.
CORRECTIVE ACTION NEEDED FOR COMPLIANCE AND N/A DAYS GIVEN
BEFORE REINSPECTION. (Note: There will be $49 re-inspect fee payable to the
Inspector by check upon each return visit.)
NONE
This is a RENEWAL application; there are 45 dogs being kept on the property that are all
properly vaccinated and contained appropriately.
Deputy Enforcement Agent & Badge #: ROMERO #4 __ Date: 1/20/21
October 2015

RABIES VACCINATION CERTIFICATE
NASPHV FORM 51 (Revised 2007)
RABIES TAG #_00000000000000000000
MICROCHIP #
Owner's Name & Address TELEPHONE #
Burtner Kennels License # K19-000036 (602) 486-2928
Address: City, State Zip:
1509 N 194th Ave Buckeye, AZ 85396
Animal Name: Weight: Predominant Breed:
Roxy 4 Poodle
2 ies: Age: Color: .
taie 2 Yrs. 0 Mos: Black
Sex: Female
DATE VACCINATED: Product Name: Veterinarian's Name:
‘|
10/28/2019 Rabies Vaccination Mary Kate Burdick, DVM
Manufacturer:
Rabvac 3 License Number: 4660
NEXT VACCINATION
DUE BY: USDA LICENSED VACC
10/28/2022 3
C975375A Veterinarian's Signature
Vaccine Serial (Lot) No.
Address:
HARMONY VETERINARY HOSPITAL
1745 W. GLENDALE AVE
PHOENIX, AZ 85021
Phone: (602) 249-1900

/
RABIES VACCINATION CERTIFICATE
NASPHV FORM 51 (Revised 2007)
RABIES TAG # 00000000000000000000
MICROCHIP #
Owner's Name & Address TELEPHONE #
Burtner Kennels License # K21-000036 (602) 486-2928
Address: City, State Zip:
1509 N 194th Ave Buckeye, AZ 85396
Animal Name: Weight: Predominant Breed:
Teddy Bear 5 Poodle
oe Age: .
=m 1 Yrs. 4 Mos. pete
Sex: Male
DATE VACCINATED: Product Name: Veterinarian's Name:
11/17/2020 Rabies Vaccination Mary Kate Burdick, DVM
Manufacturer:
Zoetis License Number: 4660
NEXT VACCINATION
DUE BY: USDA LICENSED VACC
11/17/2023 3
359644A Veterinarian's Signature
Vaccine Serial (Lot) No.
Address:
HARMONY VETERINARY HOSPITAL
1745 W. GLENDALE AVE
PHOENIX, AZ 85021
Phone: (602) 249-1900

)
RABIES VACCINATION CERTIFICATE v
NASPHV FORM 51 (Revised 2007)
RABIES TAG # 00000000000000000000
MICROCHIP #
Owner's Name & Address TELEPHONE #
Burtner Kennels License # K19-000036 (602) 486-2928
Address: City, State Zip:
1509 N 194th Ave Buckeye, AZ 85396
Animal Name: Weight: Predominant Breed:
Jill 12 Pug, Chinese
. Age: .
cm 4 Yrs. 0 Mos. oma
Sex: Female
DATE VACCINATED: Product Name: Veterinarian's Name:
10/28/2019 Rabies Vaccination Mary Kate Burdick, DVM
Manufacturer:
Rabvac 3 License Number: 4660
NEXT VACCINATION
DUE BY: USDA LICENSED VACC
10/28/2022 3
C975375A Veterinarian's Signature
Vaccine Serial (Lot) No.
Address:
HARMONY VETERINARY HOSPITAL
1745 W. GLENDALE AVE
PHOENIX, AZ 85021
Phone: (602) 249-1900

RABIES VACCINATION CERTIFICATE
/
NASPHV FORM 51 (Revised 2007)
RABIES TAG #_00000000000000000000
MICROCHIP #
Owner's Name & Address TELEPHONE #
Burtner Kennels License # K19-000036 (602) 486-2928
Address: City, State Zip:
1509 N 194th Ave Buckeye, AZ 85396
Animal Name: Weight: Predominant Breed:
Jack 15 Pug, Chinese
Age:
Species: Color:
; 4 Yrs. 0 Mos.
Canine Fawn
Sex: Male
DATE VACCINATED: Product Name: Veterinarian's Name:
40/28/2019 Rabies Vaccination Mary Kate Burdick, DVM
Manufacturer:
Rabvac 3 License Number: 4660
NEXT VACCINATION
DUE BY: USDA LICENSED VACC
10/28/2022 3
C975375A Veterinarian's Signature
Vaccine Serial (Lot) No.
Address:
HARMONY VETERINARY HOSPITAL
1745 W. GLENDALE AVE
PHOENIX, AZ 85021
Phone: (602) 249-1900

RABIES VACCINATION CERTIFICATE
NASPHV FORM 51 (Revised 2007)
RABIES TAG # 00000000000000000000
MICROCHIP #
Owner's Name & Address TELEPHONE #
Burtner Kennels License # K19-000036 (602) 486-2928
Address: City, State Zip:
1509 N 194th Ave Buckeye, AZ 85396
Animal Name: Weight: Predominant Breed:
Spizer 12 Pug, Chinese
. Age:
Species: Color:
, 3 Yrs. 0 Mos.
Canine Black
Cass ‘Famdls
DATE VACCINATED: Product Name: Veterinarian's Name:
10/28/2019 Rabies Vaccination Mary Kate Burdick, DVM
Manufacturer:
Rabvac 3 License Number: 4660
NEXT VACCINATION
DUE BY: USDA LICENSED VACC
10/28/2022 3
C975375A Veterinarian's Signature
Vaccine Serial (Lot) No.
Address:
HARMONY VETERINARY HOSPITAL
1745 W. GLENDALE AVE
PHOENIX, AZ 85021
Phone: (602) 249-1900

J
RABIES VACCINATION CERTIFICATE
NASPHV FORM 951 (Revised 2007)
RABIES TAG #_00000000000000000000
MICROCHIP #
Owner's Name & Address TELEPHONE #
Burtner Kennels License # K19-000036 (602) 486-2928
Address: City, State Zip:
1509 N 194th Ave Buckeye, AZ 85396
Animal Name: Weight: Predominant Breed:
Walley 20 Terrier, Boston
. Age: Color:
Species:
; 2 Yrs. 0 Mos. 7
Canine Black and White
cam sais
DATE VACCINATED: Product Name: Veterinarian's Name:
10/28/2019 Rabies Vaccination Mary Kate Burdick, DVM
Manufacturer:
Rabvac 3 License Number: 4660
NEXT VACCINATION
DUE BY: USDA LICENSED VACC
10/28/2022 3
Veterinarian's Signature
C975375A
Vaccine Serial (Lot) No.
Address:
HARMONY VETERINARY HOSPITAL
1745 W. GLENDALE AVE
PHOENIX, AZ 85021
Phone: (602) 249-1900

RABIES VACCINATION CERTIFICATE
NASPHV FORM 51 (Revised 2007)
RABIES TAG # 00000000000000000000
MICROCHIP #
Owner's Name & Address TELEPHONE #
Burtner Kennels License # K19-000036 (602) 486-2928
Address: City, State Zip:
1509 N 194th Ave Buckeye, AZ 85396
Animal Name: Weight: Predominant Breed:
Pepa 90 Bulldog, English
a Age: .
wpec ies: “ 8 Yrs. 0 Mos. erate :
Sex: Female
DATE VACCINATED: Product Name: Veterinarian's Name:
10/28/2019 Rabies Vaccination Mary Kate Burdick, DVM
Manufacturer:
Rabvac 3 License Number: 4660
NEXT VACCINATION
DUE BY: USDA LICENSED VACC
10/28/2022 3
Veterinarian's Signature
C975375A
Vaccine Serial (Lot) No.
Address:
HARMONY VETERINARY HOSPITAL
1745 W. GLENDALE AVE
PHOENIX, AZ 85021
Phone: (602) 249-1900

RABIES VACCINATION CERTIFICATE
NASPHV FORM 51 (Revised 2007)
RABIES TAG #_00000000000000000000
MICROCHIP #
Owner's Name & Address TELEPHONE #
Burtner Kennels License # K19-000036 (602) 486-2928
Address: City, State Zip:
1509 N 194th Ave Buckeye, AZ 85396
Animal Name: Weight: Predominant Breed:
Chopper 80 Bulldog, English
F Age:
Species: Color:
j 5 Yrs. 0 Mos. ‘
Canine Black and White
Sax: ‘Mais
DATE VACCINATED: Product Name: Veterinarian's Name:
10/28/2019 Rabies Vaccination Mary Kate Burdick, DVM
Manufacturer:
Rabvac 3 License Number: 4660
NEXT VACCINATION
DUE BY: USDA LICENSED VACC
10/28/2022 3
Veterinarian's Signature
C975375A
Vaccine Serial (Lot) No.
Address:
HARMONY VETERINARY HOSPITAL
1745 W. GLENDALE AVE
PHOENIX, AZ 85021
Phone: (602) 249-1900

/
RABIES VACCINATION CERTIFICATE
NASPHV FORM 51 (Revised 2007)
RABIES TAG # _00000000000000000000
MICROCHIP #
Owner's Name & Address TELEPHONE #
Burtner Kennels License # K19-000036 (602) 486-2928
Address: City, State Zip:
1509 N 194th Ave Buckeye, AZ 85396
Animal Name: Weight: Predominant Breed:
uf
Japper Jury 3 Poodle
:
— Age: Color:
Species:
, 4 Yrs. 0 Mos.
Canine Black
oar Male
DATE VACCINATED: Product Name: Veterinarian's Name:
10/28/2019 Rabies Vaccination Mary Kate Burdick, DVM
Manufacturer:
Rabvac 3 License Number: 4660
NEXT VACCINATION
DUE BY: USDA LICENSED VACC
10/28/2022 3
C975375A Veterinarian's Signature
Vaccine Serial (Lot) No.
Address:
HARMONY VETERINARY HOSPITAL
1745 W. GLENDALE AVE
PHOENIX, AZ 85021
Phone: (602) 249-1900

RABIES VACCINATION CERTIFICATE
NASPHV FORM 51 (Revised 2007)
RABIES TAG # 00000000000000000000
MICROCHIP #
Owner's Name & Address TELEPHONE #
Burtner Kennels License # K19-000036 (602) 486-2928
Address: City, State Zip:
1509 N 194th Ave Buckeye, AZ 85396
Animal Name: ow QU Weight: Predominant Breed:
5N
Sownie 10 Poodle Mix
5 Age:
Species: Color:
: 2 Yrs. 0 Mos. .
Canine White
Sex: Male
DATE VACCINATED: Product Name: Veterinarian's Name:
10/28/2019 Rabies Vaccination Mary Kate Burdick, DVM
Manufacturer:
Rabvac 3 License Number: 4660
NEXT VACCINATION
DUE By: USDA LICENSED VACC
10/28/2022 3
C975375A Veterinarian's Signature
Vaccine Serial (Lot) No.
Address:
HARMONY VETERINARY HOSPITAL
1745 W. GLENDALE AVE
PHOENIX, AZ 85021
Phone: (602) 249-1900

/
RABIES VACCINATION CERTIFICATE
NASPHV FORM 51 (Revised 2007)
RABIES TAG # 00000000000000000000
MICROCHIP #
Owner's Name & Address TELEPHONE #
Burtner Kennels License # K19-000036 (602) 486-2928
Address: City, State Zip:
1509 N 194th Ave Buckeye, AZ 85396
Animal Name: Weight: Predominant|Breed:
Raggs 7 Poodle Mix
Species: Age: Color:
Ceatibe 4 Yrs. 0 Mos.
Brown
Sex: Female
DATE VACCINATED: Product Name: Veterinarian's Name:
10/28/2019 Rabies Vaccination Mary Kate Burdick, DVM
Manufacturer:
Rabvac 3 License Number: 4660
NEXT VACCINATION
DUE BY: USDA LICENSED VACC
10/28/2022 3
C975375A Veterinarian's Signature
Vaccine Serial (Lot) No.
Address:
HARMONY VETERINARY HOSPITAL
1745 W. GLENDALE AVE
PHOENIX, AZ 85021
Phone: (602) 249-1900

RABIES VACCINATION CERTIFICATE
NASPHV FORM 51 (Revised 2007)
RABIES TAG #_00000000000000000000
MICROCHIP #
Owner's Name & Address TELEPHONE #
Burtner Kennels License # K19-000036 (602) 486-2928
Address: City, State Zip:
1509 N 194th Ave Buckeye, AZ 85396
Animal Name: Weight: Predominant Breed:
Hersey 6 Poodle
‘ Age:
Species: Color:
é 2 Yrs. 0 Mos.
Canine Brown
— Sos
DATE VACCINATED: Product Name: Veterinarian's Name:
10/28/2019 Rabies Vaccination Mary Kate Burdick, DVM
Manufacturer:
Rabvac 3 License Number: 4660
NEXT VACCINATION
DUE BY: USDA LICENSED VACC
10/28/2022 3
Veterinarian's Signature
C975375A
Vaccine Serial (Lot) No.
Address:
HARMONY VETERINARY HOSPITAL
1745 W. GLENDALE AVE
PHOENIX, AZ 85021
Phone: (602) 249-1900

v
CERTIFICATE
RABIES VACCINATION
NASPHV FORM 51 (Revised 2007)
RABIES TAG #_00000000000000000000
MICROCHIP #
Owner's Name & Address TELEPHONE #
Burtner Kennels License # K19-000036 (602) 486-2928
Address: City, State Zip:
1509 N 194th Ave Buckeye, AZ 85396
Animal Name: Weight: Predominant|Breed:
Baby 7 Poodle
. Age: Color:
Species:
‘ 2 Yrs. 0 Mos.
Canine Black
ene Heniais
DATE VACCINATED: Product Name: Veterinarian's Name:
10/28/2019 Rabies Vaccination Mary Kate Burdick, DVM
Manufacturer:
Rabvac 3 License Number: 4660
NEXT VACCINATION
DUE BY: USDA LICENSED VACC
10/28/2022 3
Veterinarian's Signature
C975375A
Vaccine Serial (Lot) No.
Address:
HARMONY VETERINARY HOSPITAL
1745 W. GLENDALE AVE
PHOENIX, AZ 85021
Phone: (602) 249-1900

RABIES VACCINATION CERTIFICATE
NASPHV FORM 51 (Revised 2007)
RABIES TAG #_00000000000000000000
MICROCHIP #
Owner's Name & Address TELEPHONE #
Burtner Kennels License # K19-000036 (602) 486-2928
Address: City, State Zip:
1509 N 194th Ave Buckeye, AZ 85396
Animal Name: Weight: Predominant Breed:
Falcon 7 Poodle Mix
— Age:
Species: Color:
: 2 Yrs. 0 Mos. .
Canine White
Sex: Male
DATE VACCINATED: Product Name: Veterinarian's Name:
10/28/2019 Rabies Vaccination Mary Kate Burdick, DVM
Manufacturer:
Rabvac 3 License Number: 4660
NEXT VACCINATION
DUE BY: USDA LICENSED VACC
10/28/2022 3
C975375A Veterinarian's Signature
Vaccine Serial (Lot) No.
Address:
HARMONY VETERINARY HOSPITAL
1745 W. GLENDALE AVE
PHOENIX, AZ 85021
Phone: (602) 249-1900

7
RABIES VACCINATION CERTIFICATE
NASPHV FORM 51 (Revised 2007)
RABIES TAG #_00000000000000000000
MICROCHIP #
Owner's Name & Address TELEPHONE #
Burtner Kennels License # K21-000036 (602) 486-2928
Address: City, State Zip:
1509 N 194th Ave Buckeye, AZ 85396
Animal Name: Weight: Predominant Breed:
Blue 15 Terrier, Boston
— Age: .
— 12 Mos. 0 Wks. 0 Days eat
Sex: Female
DATE VACCINATED: Product Name: Veterinarian's Name:
11/17/2020 Rabies Vaccination Mary Kate Burdick, DVM
Manufacturer:
Zoetis License Number: 4660
NEXT VACCINATION
DUE BY: USDA LICENSED VACC
11/17/2021 1
359644A Veterinarian's Signature
Vaccine Serial (Lot) No.
Address:
HARMONY VETERINARY HOSPITAL
1745 W. GLENDALE AVE
PHOENIX, AZ 85021
Phone: (602) 249-1900

RABIES VACCINATION CERTIFICATE
NASPHV FORM 51 (Revised 2007)
RABIES TAG #_00000000000000000000
MICROCHIP #
Owner's Name & Address TELEPHONE #
Burtner Kennels License # K21-000036 (602) 486-2928
Address: City, State Zip:
1509 N 194th Ave Buckeye, AZ 85396
Animal Name: Weight: Predominant Breed:
Cherry 25 Terrier, Boston
. Age:
Species: Color:
: 12 Mos. 0 Wks. 1 Days .
Canine Black/White
Sex: Female
DATE VACCINATED: Product Name: Veterinarian's Name:
11/17/2020 Rabies Vaccination Mary Kate Burdick, DVM
Manufacturer:
Zoetis License Number: 4660
NEXT VACCINATION
DUE BY: USDA LICENSED VACC
11/17/2021 1
359644A Veterinarian's Signature
Vaccine Serial (Lot) No.
Address:
HARMONY VETERINARY HOSPITAL
1745 W. GLENDALE AVE
PHOENIX, AZ 85021
Phone: (602) 249-1900