GRAVES LABRADOR RETRIEVERS KENNEL PERMIT (K19-000068).PDF

Maricopa County
Animal Care And Control
2500 South 27th Avenue
Phoenix, AZ 85009
(602) 506-7387 Tele.
(602) 506-2739 Fax
KENNEL PERMIT APPLICATION
IR New El Renewal Permit #
Genie Graves Graves Labrador Retrievers
Name: Kennel Name:
24439 N. 195th Ave Surprise, Arizona
Mailing Address: Kennel Location:
C ity Surprise ZIP 85387 County Supervisorial District Maricopa
Home Phone: 623-810-9765 623-810-9765
Kennel Phone:
Please complete and sign this application and return it to the above address with payment in the amount of
three hundred fifty dollars ($350.00) within ten (10) days of receipt.
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.
§ 11-1001(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 for a scheduled inspection and/or failure of inspection will warrant a Subsequent
Inspection Return fee of $49 for each additional visit. Failure of inspection may result in denial of the kennel
permit and require individual licensing of each dog under the provisions of A.R.S. §11-1008.
PLEASE ANSWER THE FOLLOWING QUESTIONS AND INITIAL EACH RESPONSE
1. I/We assume complete responsibility for the kennel at the premises for which I/we are making
application 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. I/We certify that I/We have 30 dogs and that the kennel meets the definition in statute.
3. I/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).
I/VVe certify that all dogs over the age of three (3) months that are kept, harbored or maintained on the
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
maint4iried on the premises for each dog.
5. JS I /We certify that I/We are submitting a valid copy of the rabies vaccination certificate for each
dog with this application.
I/VVe understand that a dog remaining within the kennel is not required to be licensed individually under
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.
7. /0"" I/We understand that a person who fails to obtain a kennel permit under A.R.S.§11-1009 is subject to a
pehalty,of twenty-five dollars in addition to the annual fee.
8. ,v1-0"- I/We understand that a person who knowingly fails to obtain a kennel permit within thirty days after
written notification from the county enforcement agent is guilty of a class 2 misdemeanor..
9. r The undersigned understand that that the kennel permit does not authorize the operation of any type
of business and is solely used for the purpose of licensing multiple dogs.
I/We certify that all of the information l/We pave provided is true and accurate under penalty of law.
Applicant Signature Date:
Applicant Signature Date:
For Official Use Only:
Copies of Valid Rabies Vaccination Certificates for each dog attached
Copy of Person's Valid Identification Attached
Type of Identification submitted
BOS Approval Date Term of Permit
2 of 2

Nlaricopa County Animal Care and Control
2500 S. 27th Avenue
Phoenix, AZ 85009-6797
(602) 506-7387
http://pets.maricoba.dov
Receipt Number: R19-751845 Receipt Date: 04/02/2019
Person ID: P2787130
Phone: 623 8109765
GRAVES LABRADOR RETRIEVERS KENNELS 4/2/2019 12:40:02PM
24439 N 195TH AVE
SURPRISE, AZ 85387
Item: Animal ID: Reference No: Price: Each: Amount:
KEN PERMIT A7777777 K19-000068 $350.00 1 $350.00
Total Fees Due: $350.00
Payments: Cash:
Check: $350.00
Credit Card:
Total Payments Received: $350.00
Thank You!
Would you like to share your experience with our service to you? Change: $0.00
Please visit our website at http://pets.maricopa.gov and click on Balance Due: $0.00
"Contact Us" to email your comments for our review.
Animal Information:
A7777777 KENNEL PERM - BORN 9/14/1999, SPAYED, UNKNOWN/MIX, TRICOLOR DOG
License Information:
Tag Number: License Expires: Animal# Vacc Date: Vacc Expires:
Please retain this receipt with your pet's records
andrewsa WBUSOFF

Maricopa County
Animal Care & Control
2500 South 27th Avenue
Phoenix, AZ 85009
Phone: (602) 506-7387
pets.maricopa.gov
KENNEL PERMIT K19-000068
PREMISE INSPECTION
Number of Dogs: 30
Name: GENIA GRAVES Kennel Name: GRAVES LABRADOR RETRIEVERS
Mailing Address: 24439 NORTH 195TH AVENUE Kennel Address: Same
City: SURPRISE State: AZ Zip: 85387 City: SURPRISE Zip: 85387
County Supervisorial District: 4
Phone: 623-810-9765 Kennel Phone: 623-810-9765
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.)
There are 30 dogs on the kennel property; all dogs are currently vaccinated for rabies and
enclosed in a controlled area.
Deputy Enforcement Agent & Badge #: Lt AMBER ROMERO #4 Date: 4-16-19
October 2015

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