SHANTE AFGHANS KENNEL PERMIT RENEWAL.PDF

Maricopa County
Animal Care and Control
2500 South 27th Avenue
Phoenix, AZ 85009
(602) 506-7387 Tel e.
(602) 506-2739 Fax
KENNEL PERMIT KIS - 0 0002- 3
APPLICATION
El New 1;2 Renewal
Name: irqfr o °
Mailing Address: Z53:494/ 41 A(vn le e LI Kennel Address: ,S'Ory,
City: e ei r f t— State: AZ Zip: 51:5-CS' City: Zip:
County Supervisorial District: 44r 4
Phone: O. 5 - 'Pa - 9 23 Kennel Phone: "/Aq :9S .9
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 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 $4 per month for unaltered dog and $2 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.
§ 11-1001(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 he approved by, the Marlowe 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-
I OM.
PLEASE ANSWER THE FOLLOWING QUESTIONS AND INITIAL EACH RESPONSE
1. 1Y 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. 11440 INVe certify that 1/We have Iegi dogs and that the kennel meets the definition in statute.
3: 11119 INVe•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.
5. -)14D I /We certify that I/VVe are submitting a valid copy of the rabies vaccination certificate for each
dog with this application.
6. _&0 INVe 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. WO I/We understand that a person who fails to obtain a kennel permit under A.R.S.§11-1009 is subject to a
penalty of twenty-five dollars in addition to the annual fee.
8. 'AO 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. 714f3 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 I/We have provided is true and accurate under penalty of law.
Applicant Signature 714-t.,Apti Date: 4/
• • /
Applicant Signature Date:
For Official Use Only:
Copies of Valid Rabies Vaccination Certificates for each dog attached
Copy of Person's Valid Identification Attached
4 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
htt0://pets.maricoiDa.dov
Receipt Number: R18 -347941 Receipt Date: 01/24/2018
Person ID: P1224832
Phone: 623 4129739
SHANTE AFGHANS KENNELS 1/24/2018 1:39:49PM
6824 W KAREN LEE LN
PEORIA, AZ 85382
Item: Animal ID: Reference No: Price: Each: Amount:
KEN PERMIT A7777777 K18-000023 $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
saucedos WBUSOFF

Maricopa County
Animal Care & Control
2500 South 276 Avenue
Phoenix, AZ 85009
Phone: (602) 506-7387
pets.maricopa.gov
KENNEL PERMIT K18-000023
PREMISE INSPECTION
Number of Dogs: 12
Name: Marilyn Domhoff Kennel Name: Shante Afghans Kennels
Mailing Address: 6824 W Karen Lee Ln Kennel Address: Same
City: Peoria AZ Zip: 85382 City: Buckeye Zip: 85326
County Supervisorial District: 4
Phone: 623-412-9739 Kennel Phone: 623-412-9739
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: Kennel has been previously inspected and there is no history of violations at the
address.
Deputy Enforcement Agent & Badge #: Lt Amber Romero RC4 Date: 1/24/18
October 2015

2 VIRUS 2 VIRUS
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