SPRINGBROOK KENNELS PERMIT APPLICATION.PDF

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Maricopa County
Animal Care And Control
2500 South 27th Avenue
Phoenix, AZ 85009
(602) 506-7387 Tele.
(602) 506-2739 Fax
KENNEL PERMIT APPLICATION
109-0000o t/
Cifl New Renewal Permit #
Name: 1.4LE JANE oOkS Kennel Name: pR)(116"3Roolc ke 11441eLs
Mailing Acldressj 4b/y 1 51; Kennel Location: g 4phl d13101 t
City Av e,A15,--- - ZIP o County Supervisorial District insim., ee.),A 3
Home Phone: --ver47-ed Kennel Phone: 9s-0 78.0
Please complete and sign this application and return it to the above address with payment in the amount of three
hundred twenty eight dollars ($328.00) 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
ir I Pfr l/We assume complete responsibility for the kennel at the premises for which l/we are making
u ation for a permit and understand that "kennel" means an enclosed, controlled area, inaccessible to other
ant ls , in which a person keeps, harbors or maintains five or more dogs under controlled conditions (ARS 11-
1001).
4/ INVe certify that IANe have dogs and that the kennel meets the definition in statute.
41,7 IANe certify that INVe have not been convicted of a violation of A.R.S. §§ 13-2910 (cruelty to animals)
1 if, 2910.01 (dog fighting), or similar violations of any other state, county or municipal animal welfare law.
(Vio tions of license and leash laws DO NOT apply).
IANe certify that all dogs over the age of three (3) months that are kept, harbored or maintained on the
es 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.
I NVe certify that INVe are submitting a valid copy of the rabies vaccination certificate for each
ith this application.
1/We understand that a dog remaining within the kennel is not required to be licensed individually under
§ 11-1008. Ilwe also understand that a dog leaving the controlled kennel conditions shall be licensed
undffr A.R.S. § 11-1008 except if the dog is only being transported to another kennel which has a permit issued
under this section.
iNVe understand that a person who fails to obtain a kennel permit under A.R.S.§11-1009 is subject to a
of twenty-five dollars in addition to the annual fee.
IANe understand that a person who knowingly fails to obtain a kennel permit within thirty days after
notification from the county enforcement agent is guilty of a class 2 misdemeanor..
The undersigned understand that that the kennel permit does not authorize the operation of any type
siness and is solely used for the purpose of licensing multiple dogs.
INVe certify that all of the information 1/We have provided is true and accurate under penalty of law.
40e
Applicant Signature AN. , .4111/40,- Date:
Applicant Signature Date: -
For Official 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

Maricopa County Animal Care and Control
2500 S. 27th Avenue
Phoenix, AZ 85009-6797
(602) 506-7387
http://pets.maricopa.gov
Receipt Number: R18-520648 Receipt Date: 07/27/2018
Person ID: P0999286
Phone: 480 4881780
SPRINGBROOK KENNELS 7/27/2018 12:34:13PM
36614 N 23RD ST
CAVE CREEK, AZ 85331
Item: Animal ID: Reference No: Price: Each: Amount:
KEN PERMIT A7777777 K19-000004 $328.00 1 $328.00
Total Fees Due: $328.00
Payments: Cash:
Check: $328.00
Credit Card:
Total Payments Received: $328.00
Thank You!
Would you like to share your experience with our service to you? Change: $0.00
Please visit our website at http://pets.rnaricopa.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
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Maricopa County
Animal Care & Control
2500 South 27 111 Avenue
Phoenix, AZ 85009
Phone: (602) 506-7387
pets.maricopa.gov
KENNEL PERMIT K19-000004
PREMISE INSPECTION
Number of Dogs: 5
Name: Lue Jeane Brooks Kennel Name: Springbrook Kennels
Mailing Address: 36614 N 23 rd St Kennel Address: Same
City: Phoenix State: AZ Zip:85086 City: Phoenix Zip: 85086
County Supervisorial District: 3
Phone: 480-488-1780 Kennel Phone: 480-488-1780
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.)
No follow up necessary. Kennel property was inspected 8/13/18; all dogs on property are
properly vaccinated and vaccine certificates have been provided. Property is enclosed and
all dogs are secured to the property.
Deputy Enforcement Agent & Badge #: Lt. Amber Romero Date: 8113118
October 2015

CEIFITIFECATE
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Thank you for your payment.
Please print this receipt and keep it for your records.
Unique ID: 32DB9B8C4CC54A02B960C5EF413907A8D
Description : P01174701P16-500270
Invoice ID: MRCP/2493508
Payment
$50.00
Amount:
Receipt Number: 3681704816
Transaction Date: 0812312016 04:51 PM
Payment Type: VISA
• •....-..4603
_ RABIES VACCINATION CERTIFICATE
YAVAPAI COUNTY ANIMAL CONTROL PHONE 771-3260 RABIESNO.
45fLEAST GURLEY • PREscorr, AZ
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Desert Hills Animal Clinic ) niv3-0/i/
www.dhanimalclinic.com
1039 E. Carefree Hwy Ste. A
Phoenix, AZ 85085
(623) 581-1558
Rabies Certificate
Patient ID:
Client ID: 773
Patient Nan: Bristol
Client Name: Lue Jeane Brooks
Species:
Address: 36614 N 23rd St Breed: Spaniel, English Springer
Sex: Female
Desert Hills, AZ 85086
Color: Black/Tan/White
Phone: (602)579-8200 Markings:
Birthday: 08/24/2013
Weight: 33.30 pounds on 9/8/2017
Microchip ID: 985121008357762
Tag Number: 39228 Vaccination Date: 1/26/2018
Lot Number: 12636 Expiration Date: 1/2612021
Inventory Rabies Vaccine
Producer: Merial
K / MLV / R: Killed Virus
Staff Name: Jennifer L. Fitzpatrick, DVNI
License Number: 4357

Desert Hills Animal Clinic //
www.dhanimalclinio.com )1 Loeey
1039 E. Carefree Hwy Ste. A
Phoenix, AZ 85086
(623) 581-1558
Rabies Certificate
Patient ID: 42872
Patient Name: Lacey
Client ID; 773 Species: Canine
Client Name: Lue Jeane Brooks Breed: Spaniel, English Springer
Address: 36614 N 23rd Si Spayed Female
Sex:
Desert Hills, AZ 85086 Color: Black/White
Markings:
Phone, (802)579-6200 Birthday: 11/02/2017 pounds on 6/2/2018
Weight: 32.60
Microchip ID: 9851120101639193
Vaccination Date: 612/2018
Tag Number: 41307 Expiration Date: 61212019
Lot Number: 12639
inventory Rabies Vaccine
Producer: Menai
K / ACV / R: Killed Virus
Staff Name: Jennifer L. Fitzpatrick, DVM
License Number: 4357

Desert Hills Animal Clinic
www.dhanimalclinic.com
1039 E. Carefree Hwy Ste. A
Phoenix, AZ 85085
(623) 581-1558
Rabies Certificate
Patient.ID: 39788
Patient Name: Jackson
Client ID: 773 Species: Canine
Client Name; Lue Jearie Brooks Breed: Spaniel, English Springer
Address: 36814 N 23rd St Neutered Male
Sex:
Desert Hills, AZ 85086 Color: Liver Tri
Markings:
(602)579-8200 Birthday: 10/0812016
Phone: Weight: 49,80 pounds on 6/2/2018
Microchip ID: 985112008084043
Vaccination Date: 6/2/2018
Tag Number: 41306 Expiration Date: 8/2/2021
Lot. Number: 12639
Inventory Rabies Vaccine
Producer: Medal
K./ MLV / R. Killed Virus
Staff Name: Jennifer L. Fitzpatrick, DVM
License Number: 4357