JOHNSON KENNELS PERMIT RENEWAL.PDF

Maricopa County
Animal Care and Control
2500 South 27th Avenue
Phoenix, AZ 85009
(602) 506-7387 Tele.
(602) 506-2739 Fax
KENNEL PERMIT oci 0041
APPLICATION
CI New ITKRenewal
P010-101
Name In Al2-LITAILCo.ti Kennel Name: 0-6 J-1.01.56A)
Mailing Address: a-CV? E 74;44 2-44141e-- Kennel Address: ‘Z.5:i
City:Pkotipx- ' State: Zip: City:Nteceji ix Zip: RS-A-C-6
County Supervisorial District: im.A0/600p9
Phone: 6,02 /f'- ea 6, Kennel Phone:
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.
NOTE: It is suggested the renewal application be submitted 4 - 6 weeks in advance of the expiration date.
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 at time of inspection. 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. M. INVe 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. in INVe certify that I/We have 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).
4. INVe 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
maintained on the premises for each dog.
• , I NVe certify that INVe are submitting a valid copy of the rabies vaccination certificate for each
clog with this application.
IANe understand that a dog remaining within the kennel is not required to be licensed individually under
A. .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. fib INVe understand that a person who fails to obtain a kennel permit under A.R.S.§11-1009 is subject to a
penaltV of twenty-five dollars in addition to the annual fee.
8. 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. A ,r he undersigned understand that that the kennel permit does not authorize the operation of any type
of busy ess and is solely used for the purpose of licensing multiple dogs.
I/We certify that all of the information INVe have provided is true and accurate under penalty of law.
Applicant Signature Date: ,di(s21
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
October 2015

Maricopa County Animal Care and Control
2500 S. 27th Avenue
Phoenix, AZ 85009-6797
(602) 506-7387
http://bets.maricopa.gov
Receipt Number: R18-371838 Receipt Date: 02118/2018
Person ID: P1970707
Phone: 602 6204067
JOHNSON MARY KENNELS 2/18/2018 9:53:52AM
2527 E TONTO LN
PHOENIX, AZ 85050
Item: Animal ID: Reference No: Price: Each: Amount:
KEN PERMIT A7777777 KI9-000047 $328.00 $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.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
schenone WBUSOFF

Maricopa County
Animal Care & Control
2500 South 27'h Avenue
Phoenix, AZ 85009
Phone: (602) 506-7387
pets.maricopa.gov
KENNEL PERMIT K 14-000047
PREMISE INSPECTION
Number of Dogs: 10
Name: Mary Johnson Kennel Name: Johnson Kennels
Mailing Address: 2527 E. Tonto Ln Kennel Address: Same
City: Phoenix State: AZ Zip:85050 City: Phoenix Zip: 85050
County Supervisorial District: 3
Phone: 602-741-6366 Kennel Phone: 602-703-6082
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 kennel has been previously inspected and passed; there have not been any
issues at the address listed for the kennel, to report.
Deputy Enforcement Agent & Badge #: Lt. Amber Romero Date: 02/15/18
October 2015

CERTIFICATE OF VACC
Date of Vaccination: 12-19-17 Certificate No. 0
Next Vaccination on: 12-18-20 Previous Vaccination:
VETERINARY CLINIC OWNER OF ANIMAL
Indian Bend Animal Hospital Mary Johnson
3923 E. Thunderbird Road 2527 E.Tonto Ln.
Phoenix, AZ 85032 Phoenix, AZ 85050
602-867-2992 (602) 569-3373
This is to certify...
THAT I HAVE VACCINATED THE ANIMAL DESCRIBED BELOW AGAINST RABIES.
Patient information...
PATIENT: Karma TAG NO:
SPECIES: Canine BREED: Doberman Pinscher
SEX: Spayed Female AGE: 5 years
WEIGHT: 70.20 lbs COLOR: Black/Rust
MICROCHIP
MFG BY: 130E...--E.RIAL: 4150421A, EXPIRES: 12/20/17, ADMIN: Sq
Signed:
F. Isom, DVM License: 3307
Other Vaccinations...

CERTIFICATE OF VACCINATION
Date of Vaccination: 12-19-17 Certificate No. 0
Next Vaccination on: 12-18-20 Previous Vaccination:
VETERINARY CLINIC OWNER OF ANIMAL
Indian Bend Animal Hospital Mary Johnson
3923 E. Thunderbird Road 2527 E.Tonto Ln.
Phoenix, AZ 85032 Phoenix, AZ 85050
602-867-2992 (602) 569-3373
This is to certify...
THAT I HAVE VACCINATED THE ANIMAL DESCRIBED BELOW AGAINST RABIES.
Patient information...
PATIENT: Lit Bambaki TAG NO:
SPECIES: Canine BREED: Dachshund
SEX: Male AGE: 2 years
WEIGHT: 11.60 lbs COLOR: Cream
MICROCHIP
MFG BY: Boe,A SERIAL: 4150421A, EXPIRES: 12120/17, ADMIN: Sq
Signed:
F. Isom, DVIVI License: 3307
Other Vaccinations...
Vaccinated By Vaccination Next due
10-12-16 Fl Rabies-Canine lyr (none)

CERTIFICATE OF VACCINAT
Date of Vaccination: 12-19-17 Certificate No. 0
Next Vaccination on: 12-18-20 Previous Vaccination:
VETERINARY CLINIC OWNER OF ANIMAL
Indian Bend Animal Hospital Mary Johnson
3923 E. Thunderbird Road 2527 ETonto Ln.
Phoenix, AZ 85032 Phoenix, AZ 85050
602-867-2992 (602) 569-3373
This is to certify...
THAT I HAVE VACCINATED THE ANIMAL DESCRIBED BELOW AGAINST RABIES.
Patient information...
PATIENT: Mia TAG NO:
SPECIES: Canine BREED: West Highland Terrier
SEX: Female AGE: 22 months
WEIGHT: 13.90 lbs COLOR: White
MICROCHIP
MFG BY: BOE, SERIAL: 4150421A, EXPIRES: 12/20/17, ADMIN: Sg
Signed:
F. Isom, ID License: 3307
Other Vaccinations...
Vaccinated By Vaccination Next due
10-12-16 Fl Rabies-Canine lyr (none)

CERTIFICATE OF VACCINATION
Date of Vaccination: 12-19-17 Certificate No. 0
Next Vaccination on: 12-18-20 Previous Vaccination:
VETERINARY CLINIC OWNER OF ANIMAL
Indian Bend Animal Hospital Mary Johnson
3923 E. Thunderbird Road 2527 E.Tonto Ln.
Phoenix, AZ 85032 Phoenix, AZ 85050
602-867-2992 (602) 569-3373
This is to certify...
THAT I HAVE VACCINATED THE ANIMAL DESCRIBED BELOW AGAINST RABIES.
Patient information...
PATIENT: Mya TAG NO:
SPECIES: Canine BREED: West Highland Terrier
SEX: Female AGE: 22 months
WEIGHT: 11.80 lbs COLOR: White
MICROCHIP
MFG BY: BOE, SERIAL: 4150421A, EXPIRES: 12/20/17, ADM IN: Sq
Signed:
F. Isom, DVM License: 3307
Other Vaccinations...
Vaccinated By Vaccination Next due
10-12-16 Fl Rabies-Canino lyr (none)

CERTIFICATE OF VACCINATION
Date of Vaccination: 12-19-17 Certificate No. 0
Next Vaccination on: 12-18-20 Previous Vaccination:
VETERINARY CLINIC OWNER OF ANIMAL
Indian Bend Animal Hospital Mary Johnson
3923 E. Thunderbird Road 2527 E.Tonto Ln.
Phoenix, AZ 85032 Phoenix, AZ 85050
602-867-2992 (602) 569-3373
This is to certify...
THAT I HAVE VACCINATED THE ANIMAL DESCRIBED BELOW AGAINST RABIES.
Patient information...
PATIENT: Sadie TAG NO:
SPECIES: Canine BREED: Dachshund
SEX: Female AGE: 2 years
WEIGHT: 11.30 lbs COLOR: Black & Tan
MICROCHIP
MFG BY: BOEA SERIAL: 4150421A, EXPIRES: 12/20117, ADMIN: Sq
Signed:
F. Isom, DVM License: 3307
Other Vaccinations...
Vaccinated By Vaccination Next due
10-12-16 Fl Rabies-Canine 1yr (none)

CERTIFICATE OF VACCINATION
Date of Vaccination: 12-19-17 Certificate No. 0
Next Vaccination on: 12-18-20 Previous Vaccination:
VETERINARY CLINIC OWNER OF ANIMAL
Indian Bend Animal Hospital Mary Johnson
3923 E. Thunderbird Road 2527 E.Tonto Ln.
Phoenix, AZ 85032 Phoenix, AZ 85050
602-867-2992 (602) 569-3373
This is to certify...
THAT I HAVE VACCINATED THE ANIMAL DESCRIBED BELOW AGAINST RABIES.
Patient information...
PATIENT: Shilo TAG NO:
SPECIES: Canine BREED: Dachshund
SEX: Male AGE: 2 years
WEIGHT: 11.40 lbs COLOR: Red
MICROCHIP
MFG BY: BO.,\ SENAL: 4150421A, EXPIRES: 12/20/17, ADMIN: Sq
Signed:
F. Isom, DVM License: 3307
Other Vaccinations...
Vaccinated By Vaccination Next due
10-12-16 Fl Rabies-Canine lyr (none)

Date of Vaccination: 12-19-17 Certificate No. 0
Next Vaccination on: 12-18-20 Previous Vaccination:
VETERINARY CLINIC OWNER OF ANIMAL
Indian Bend Animal Hospital Mary Johnson
3923 E. Thunderbird Road 2527 E.Tonto Ln.
Phoenix, AZ 85032 Phoenix, AZ 85050
602-867-2992 (602) 569-3373
This is to certify...
THAT I HAVE VACCINATED THE ANIMAL DESCRIBED BELOW AGAINST RABIES.
Patient information...
PATIENT: Teddy TAG NO:
SPECIES: Canine BREED: Dachshund
SEX: Male AGE: 3 years
WEIGHT: 11.10 lbs COLOR: Blk & Tan
MICROCHIP
MFG BY: BOcii, S RIAL: 4150421A, EXPIRES: 12/20/17, ADMIN: Sq
Signed:
F. Isom, HIVII License: 3307
Other Vaccinations...
Vaccinated By Vaccination Next due
10-12-16 Fl Rabies-Canine 1yr (none)

Date of Vaccination: 12-19-17 Certificate No. 0
Next Vaccination on: 12-18-20 Previous Vaccination:
VETERINARY CLINIC OWNER OF ANIMAL
Indian Bend Animal Hospital Mary Johnson
3923 E. Thunderbird Road 2527 E.Tonto Ln.
Phoenix, AZ 85032 Phoenix, AZ 85050
602-867-2992 (602) 569-3373
This is to certify...
THAT I HAVE VACCINATED THE ANIMAL DESCRIBED BELOW AGAINST RABIES.
Patient information...
PATIENT: Zena TAG NO:
SPECIES: Canine BREED: Doberman Pinscher
SEX: Female AGE: 3 years
WEIGHT: 62.40 lbs COLOR: Black & Tan
MICROCHIP
MFG BY: BOE, SERIAL: 4150421A, EXPIRES: 12/20/17, ADMIN: Sq
Signed:
F. Isom. DV g License: 3307
Other Vaccinations...
Vaccinated By Vaccination Next due
10-12-16 Fl Rabies-Canine lyr (none)

CERTIFICATE OF VACCINATION
Date of Vaccination: 12-19-17 Certificate No. 0
Next Vaccination on: 12-19-18 Previous Vaccination:
VETERINARY CLINIC OWNER OF ANIMAL
Indian Bend Animal Hospital Mary Johnson
3923 E. Thunderbird Road 2527 E.Tonto Ln.
Phoenix, AZ 85032 Phoenix, AZ 85050
602-867-2992 (602) 569-3373
This is to certify..
THAT I HAVE VACCINATED THE ANIMAL DESCRIBED BELOW AGAINST RABIES.
Patient information...
PATIENT: Big Red TAG NO:
SPECIES: Canine BREED: Dachshund
SEX: Male AGE: 12 months
WEIGHT: 13.20 lbs COLOR: Red
MICROCHIP
MFG BY: BOE, SERIAL: 41,50421A, EXPIRES: 12/20/17, ADMIN: Sq
Signed:
F. Isom, DVM License: 3307
Other Vaccinations...

Date of Vaccination: 12-19-17 Certificate No. 0
Next Vaccination on: 12-19-18 Previous Vaccination:
VETERINARY CLINIC OWNER OF ANIMAL
Indian Bend Animal Hospital Mary Johnson
3923 E. Thunderbird Road 2527 E.Tonto Ln.
Phoenix, AZ 85032 Phoenix, AZ 85050
602-867-2992 (602) 569-3373
This is to certify...
THAT I HAVE VACCINATED THE ANIMAL DESCRIBED BELOW AGAINST RABIES.
Patient information...
PATIENT: Casey TAG NO:
SPECIES: Canine BREED: West Highland Terrier
SEX: Male AGE: 10 months
WEIGHT: 13.20 lbs COLOR: White
MICROCHIP
MFG BY: BOE, pERIAL: 41504,21A, EXPIRES: 12/20/17, ADMIN: Sq
Signed:
F. Isom, DVM License: 3307
Other Vaccinations...