KENNEL PERMIT FOR DONNA WILLIAMS DBA BUCKEYE BULLDOGGES.PDF

Maricopa County
Animal Care & Control
2500 South 27" Avenue
Phoenix, AZ 85009
Phone: (602) 506-7387
pets.maricopa.gov
KENNEL PERMIT K18-000060
PREMISE INSPECTION
Number of Dogs: 5
Name: Donna Williams Kennel Name: Buckeye Bulldogges
Mailing Address: 13411 S 208" Dr Kennel Address: Same
City: Buckeye State: AZ Zip:85326 City: Buckeye Zip: 85326
County Supervisorial District: 5
Phone: 602-527-0366 Kennel Phone: 602-527-0366
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 WN/A DAYS GIVEN
BEFORE REINSPECTION. (Note: There will be $49 re-inspect fee payable to the
Inspector by check upon each return visit.)
NONE
Deputy Enforcement Agent & Badge #: Lt Timothy Rummel Date: 06/16/17
October 2015

Maricopa County
Animal Care and Control
2500 South 27th Avenue
Phoenix, AZ 85009
(602) 506-7387 Tele.
(602) 506-2739 Fax
KENNEL PERMIT
-900060
K 1% °
APPLICATION
L] New Renewal
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Name: |Don Kennel Name: PuckE VE
He bulldoggess
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Address: 134) nos¥ Dé. Kennel Address: 13 oy S. Do:
Mailing
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City: Buckeye State: AZ Zip: L532 City: Pucke C¢e Zip: %, SIL
County Supervisorial District: 5
/
Phone: bl Va 7 4 a 7 - D3BCG Kennel Phone: Q 7 _ Sb
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_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
U/W
4. We assume complete responsibility for the kennel at the premises for which Ive are making
-- application fora permit and understand that “kennel” means an enclosed, controlled area, inaccessible to~ ~~

other animals, in which a person keeps, or maintains five or: more dogs | under controlled
harbors
conditi fs (ARS 11-1001). :
Sth
certify that I/We 2. dogs and that the kennel meets the definition in statute.
have
_
We.-certify that I/We have not been convicted of a violation of A.R.S. §§ 13-2910 (cruelty to animals)
3.
3-2910.01 (dog fighting), or similar violations of any other state, county or municipal anima! welfare law.
(Violation of license and leash laws DO NOT apply).
2
IMWe certify.that all dogs over the age of thes (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 gn the premises for each dog. .
5, | We certify that We are submitting a: ‘valid of the rabies vaccination certificate for each
copy
dog with this application.
A
6. iMWe understand that a dog remaining within the kennel is not required to be licensed individually under
AR.S. § 11-1008. I/we also understand that a’dog-leaving the controlled kennel conditions shall be licensed
A.R.S. § 11-1008 except if the dog is only transported to another kennel which has a permit issued
eer being
r this section.
7. We understand that a person who fails to obtain a kennel permit under A.R.S. S11 ~1009 is subject to a
pe dollars in addition to the annual fee. 7
es
8. h 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..
Mo
undersigned understand that that the kennel ‘permit does not authorize the operation of any type
of business and is solely used for the of multiple dogs.
purpose licensing
“Ss
UWe certify that all of the information I/We have provided is true and accurate under penalty of law.
seméth,
Applicant Date: 62 WZ —L!
7
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
f 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: R17-156383 Receipt Date: 06/14/2017
Person ID: P2381323
Phone: 602 5270366
BUCKEYE BULLDOGGES KENNELS
6/14/2017 11:04:57AM
13411 S 208TH DR
BUCKEYE, AZ 85326
ltem: Animal ID: Reference No: Price: Each: Amount:
KEN PERMIT Al777777 K18-000060 $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.maricopa.gov and click on Balance Due: $0.00
Contact
5	1	14	4	4	2	483	1794	60	30	96.751144	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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RABIES VACCINATION CERTIFICATE Rabies Tag Number
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MARICOPA COUNTY DOG LICENSE APPLICATION
DO NOT USE THIS APPLICATION TO RENEW A LICENSE
In Maricopa County all dogs over the age of three months are required by law to be licensed and vaccinated against rabies. Application for license must be made
within 15 days of vaccination. Residents new to Maricopa County and new dog owners must purchase a license within 30 days. bes term of license is based on the
month and day of the. most current tables vaetination on record and is valid for: no more than ‘one ecalesidey age j
To cbtaih jicene online, please is www. ‘pets. marikopa gov. To obtain your lleeiive: bi mall remit this siilindee application; a copy Lot ibtes ee
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certificate, If the veterinarian does not complete the bottom of this form, and your eheek made ig to Animal Care & Control to: Animal Care &
gaa Aig §
Control, P.O, Box 2959, Phoenix, AZ 85062-2959,
Please please a5 dhawcopse black rbtive ink ante
print. not staple or Use or
PHOTOCOPIES WILL NOT BE ACCEPTED
Your Information - Who owns this pet and where do you live?
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Your Pet’s Information - is the pet’s breed, Kewanee ? (Your veterinarian can assist with this portion)
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Your Payment Information — How much is this going to cost me?
Indicate the Amount You’re Paying
Type of Charges
License Fees:
[] Altered Dog (Spayed/Neutered): 17.00 S
C] Unaltered Dog (Male or Female): 42.00
[| 65 Years Old or Older: (Limit 2 dogs per household) $6.00 (Altered Dog Only)
Penalty/late: Calcujation Table: S
$2.00 Per Month Altered Dog 2.00 X (NO OF MONTHS) =
$4.00 Per Month Unaltered Dog 4.00 X (NO OF MONTHS) =
Voluntary donation of to save more pets lives: S
$
Your Total Cost (Enclosed Payment):
that the information contained above is true and that | am 18 years old or older and that | am owner of the dog referenced in this document:
| swear or affirm
LAA Date: CEI
Signature: Lime
TO BE COMPLETED BY THE VETERINARIAN ONLY
Year (
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(Pfizer)
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Term:
Clinic ID # (assign
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Name: (Starts with “G”)
Veterinarian’s
Signature:
RABIES
VACCINATION CERTIFICATE

LoL49519
MARICOPA COUNTY DOG LICENSE APPLICATION
DO NOT USE THIS APPLICATION TO RENEW A LICENSE
in Maricopa County all dogs over the age of three months are required by law to be licensed and vaccinated against rabies. Application for license must be made
within 15 days of vaccination. Residents new to Maricopa County and new dog owners must purchase a license within 30 one: git term of license is based on the
month and day of oe. most current rabies MAGRNGTON on record and is valid for no more than one erieniay year.
To obtain your license online, please to www. pets, Aadecbee gov. To obtain your lice by. inal samt this <rilalad snplleatlon, a copy of ratios vaccination:
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certificate, if the veterinarian does not complete the bottom permenea of this form, and your check mane pave to Animal Care & Sangh to: Aone care &
Control, Pp, 0. Box 2959; Phoenin, AZ 85062-2959.
Please don staple sieOCEY: niaex ink
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PHOTOCOPIES WILL NOT BE ACCEPTED
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Your Pet’s Information - What is the pet’s name, breed, age....... ? (Your veterinarian can assist you with this portion)
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Your Payment Information — How much is this going to cost me?
Indicate the Amount You're Paying
Type of Charges
License Fees:
[| Altered Dog (Spayed/Neutered): 17.00 S
{| Unaltered Dog (Male or Female): 42.00
[| 65 Years Old or Older: (Limit 2 dogs per household) $6.00 (Altered Dog Only)
Calculation Table: iS
Penalty/Late:
$2.00 Per Month Altered Dog 2.00 X (NO OF MONTHS) =
$4.00 Per Month Unaltered Dog 4.00 X (NO OF MONTHS) =
Voluntary donation of to save more pets lives: $
S
Your Total Cost (Enclosed Payment):
contained above is true and that | am 18 years old or older and that | am owner of the dog referenced in this document:
| swear or affirm that
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Date: bo 17
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Signature:
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To BE TED BY THE VETERINARIAN ONLY
Day (DD) Year (YYY
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Term:
se Clinic ID # (assign
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Name: (Starts with “G”)
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Signature:
THIS LICENSE APPLICATION IS NOT A STAND-ALONE
RABIES VACCINATION CERTIFICATE

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