BUCKEYE BULLDOGGES - KENNEL PERMIT.PDF

Maricopa County Animal Care and Control
2500 S. 27th Avenue
Phoenix, AZ 85009-6797
(602) 506-7387
hito://pets.maricopa.qov
Receipt Number: R16-168312 Receipt Date: 07/14/2016
Person ID: P2381323
Phone: 602 5270366
BUCKEYE BULLDOGGES
7/14/2016 10:43:58AM AQ:
13411 S 208TH DR
BUCKEYE, AZ 85326
Item: . Animal ID: Reference No: Price: Each: Amount:
KEN PERMIT AT777777 K17-000060 $328.00 4 $328.00
Total Fees Due: $328.00
Payments: Cash: $0.00
Check: $328.00
Credit Card: $0.00
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	12	3	1	2	474	1786	60	31	96.787682	Us to email your comments for our review.
Animal {nformation:
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
shawcrof EBUSOFF

Maricopa County
Animal Care and Control
2500 South 27th Avenue
Phoenix, AZ 85009
(602) 506-7387 Tele.
(602) 506-2739 Fax
KENNEL PERMIT K17-000060
APPLICATION
C1 New £ Renewal
Name: Donna Williams Kennel Name: Buckeye Bulldogges
Mailing Address: 13411 S 208" Ave 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
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.
EASE ANSWER THE FOLLOWING QUESTIONS AND INITIAL EACH RESPONSE
e€ 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
conditigns (ARS 11-1001).
e certify that I/We nave dogs and that the kennel meets the definition in statute.
e certify that I/We have not been convicted of a violation of A.R.S. §§ 13-2910 (cruelty to animals)
of 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).
mlbsive
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 orrthe premises for each dog.
e certify that Ie are submitting a valid copy of the rabies vaccination certificate for each
e 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 seetion.
e understand that a person who fails to obtain a kennel permit under A.R.S.§11-1009 is subject to a
twenty-five dollars in addition to the annual fee.
undersigned understand that that the kennel permit does not authorize the operation of any type
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 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 & Control
2500 South 27" Avenue
Phoenix, AZ 85009
Phone: (602) 506-7387
pets.maricopa.gov
KENNEL PERMIT K17-000060
PREMISE INSPECTION
Number of Dogs: 6
Name: Donna Williams Kennel Name: Buckeye Bulldogges
Mailing Address: 13411 S 208 Ave Kennel Address: Same
City: Buckeye State: AZ Zip: 85326 City: Phoenix 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
of a valid rabies vaccination certificate?
=
2. Is the kennel an enclosed, controlled area, inaccessible to other animals, in which a
keeps, harbors or maintains five or more dogs under controlled conditions?
as
NOTE: Copies of each rabies vaccination certificate must be attached to the Kennel Permit
Premise Inspection form.
CORRECTIVE ACTION NEEDED FOR COMPLIANCE AND 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: 7/18/16
October 2015

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VCA Smoketown Animal Hospital
2497 Old Philadelphia Pike , Lancaster, PA 17602
(717) 394 - 5542
RABIES VACCINATION CERTIFICATE
Pet’s Name: he Maple Kayne Owner: Eli Petersheim
1147 Robert Fulton Hwy
Species: Canine
Quarryville, PA 17566
Breed: Bulldog, OldeEng lish
(intact) (717) 205 - 7174
Sex: Female
Birthdate: 08/22/2015
Color: Lilac; Tri
Weight:
Vaccination information
Manufacturer: Pfizér/Zoetis Defensor 3
Duration: 1 year Serial Number: 107409B
_ Date Due: 12/16/2016 _ Lot Expiration: 12/7/2016
Tag Number: 4416
Microchip Number:
Vaccinated at VCA Smoketown Animal Hospital
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Leann Murphy, VMD
521-0366
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