BUCKEYE AZ BULLDOGGES.PDF

Maricolia County
Animal Care And Control
2500 South 27th Avenue
Phoenix, AZ 85009
(602) 506-7387 Tele.
(602) 506-2739 Fax
KENNEL PERMIT APPLICATION
New 0 Renewal Permit # /6 - 00 400 46
Name:, 1') M 01% Kennel Name: Difekeye, /7z. ija//dOCieteS
Mailing Address: PW/ ,9o8 1:)/(2, Kennel Location: uckcyc, 7
City mektye ZIP gt6--,3,6 County Supervisorial District
Home Phone: I••I 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.
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. §i 1-1008.
/ PLEASE ANSWER THE FOLLOWING QUESTIONS AND INITIAL EACH RESPONSE
P /I 4 1/We assume complete responsibility for the kennel at the premises for which 1/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-
100
e certify that 1NVe have dogs and that the kennel meets the definition in statute.
3. /VP INVe certify that 1/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. iV ft 1/We 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
maintainecOn the premises for each dog.
5. JO I /We certify that INVe are submitting a valid copy of the rabies vaccination certificate for each
dog with jhis application.
6. Tie 1/1Ale understand that a dog remaining within the kennel is not required to be licensed individually under
A.R.S. § 11-1008. Ifwe 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. it /V understand that a person who fails to obtain a kennel permit under A.R.S.§11-1009 is subject to a
penaly of jwenty-five dollars in addition to the annual fee,
& 1/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.Zihr 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.
VWe certify that all of the information liWe have provided is true and accurate under penalty of law.
Applicant Signatu Date: 7 —it5
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
2 of 2

Maricopa County Animal Care & Control
Date: August 7, 2015
Lt Timothy Rummel
Enforcement Division Lieutenant
2630 W. Rio Salado Parkway
Mesa, AZ 85201
(602) 506-6274
trummel@mail.maricopa.gov
Kennel Permit # 2016-000060
Number of Dogs — 6
KENNEL PERMIT INSPECTION
Buckeye Bulldogges / Donna Williams
13411 S 208th Dr
Buckeye, AZ 85326 (County District # 5)
602-527-0366
• Are all dogs over the age of 3 months properly vaccinated for rabies and in possession of a valid rabies
vaccination certificate? ("Properly Vaccinated" means, by a licensed veterinarian or Maricopa County Animal
Care and Control)
YES
• Is the kennel an enclosed, controlled area, inaccessible to other animals, in which a person keeps, harbors or
maintains 5 or more dogs under controlled conditions?
YES
• CORRECTIVE ACTION REQUIRED FOR COMPLIANCE - NONE
Lt Timothy Rummel
Ma ricopa County Animal Care and Control

Maricopa County Animal Care and Control
2500 S. 27th Avenue
Phoenix, AZ 85009-6797
(602) 506-7387
http://pets.maricopa.dov
Receipt Number: R15-179271 Receipt Date: 08/01/2015
Person ID: P2381323
Phone: 602 5270366
BUCKEYE BULLDOGGES 8/1/2015 1:59:59PM
13411 S 208TH DR
BUCKEYE, AZ 85326
Item: Animal ID: Reference No: Price: Each: Amount:
KEN PERMIT A7777777 K15-000060 $328.00 1 $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 Us" to email your comments for our review.
Animal Information:
A7777777 KENNEL PERM - BORN 9/14/1999, SPAYED, UNKNOWN/M1X, TRICOLOR DOG
License Information:
Tag Number: License Expires: Animal# Vacc Date: Vacc Expires:
Please retain this receipt with your pet's records
shawcrof EBUSOFF

RABIES VACCINATION CERTIFICATE Rabies Tag Number
NASPHV Form #50
Owner's Name & Address Prim. - use halt paint pen or rips
PRINT - LFst k. no
No
134 ()yr- citY'
Species: Age: Size:
Dog )St... 3 mo. to 12 mo. Under 20 lbs.
Cat Ci 12 mo. or older 20-50 lbs. 0
Name Over 50 lbs.
Woo. Serial (lot) No.
Producer: 0, 1 yr. Lic.Nacc.
(First 3 letters) 3 yr. Lic./Vacc. Other 5Y/3) 2,(—Q_
For Licensing Agency Use DATE VACCINATED: Veterinarian's: # 3
License No. Year _IS__ _LSI License No.
Month Day Year A
Stin aide—
Other VACCINATION EXPIRES:
a KM 'VETERINAPY 03:7-icEj
Change 0 Add 0
Control No. Le, g 24090 W INN. 05
S s5
Month Day Year
RABIES VACCINATION CERTIFICATE Rabies Tag Number
NASPHV Form #50
Owner's Name & Address Print - use ball point pen or type (ii,4Q
PRINT - I Tel!
, (016nno. — 03(64
met die
- Crit it Ar g7te IPS5-V(.0
Species: Sax: Age: Size: Pominant Breed: -Colors:
Dog Male 0 3 mo. to 12 mo. 0 Under 20 lbs.
Cat 0 Female 12 ma. or older\Q 20-50 lbs. 0
Name r\i'')AOLO, C‘ Over 59 lbs. Ss.
Vacc. Serial (lot) No.
Producer: 0 1yr. lic.Nacc, gig 2k?
(First 3 letters) raN3 yr. Lic.Nacc. Other 6
For Licensing Agency Use DATE VACCINATED: Veterinarian's: #
License No. Year Li G.
Month Day Year
Signature kj
Other VACCINATION EXPIRES: CREYE VETBRINARY SE1=0; 710E1
Change Add 0 24080W. HWY. 05
Control No.
Month Day Year BUCKEYE, AZ 85326
RABIES VACCINATION CERTIFICATE Rabies Tag Number
NASPHV Form #50
Owner's Name &Address Print - use ball point pen or type
Species: Age: Size: Predo inan Breed:
Bog N1))4 $ mo. to 12 me. 0 Under 20 lbs. 0 01
Cat Female 12 mo. or alder 20-50 lbs.
Name Over 50 lbs. 'EL. 6)<MOq
Vacc. Serial (lot) No.
Producer: 01 yr. Lic,Nacc.
(First 3 letters) 3 yr. Lic.Nacc. Other 6//2/
For Licensing Agency Use DATE C.9 VACCINATED:
Veterinarian's: #
License No. Year
3_ _iS :^
Month Day Year
Signature
Other VACCINATION EXPIRES: 13C11:YE'Vill'TITZ:ZNARIZ SJO
Change I01 Add 24090 W. I-IWY. C5
Control No.
Month Day Year illiCKEIT4 Az e5326

RABIES VACCINATION CERTIFICATE Rabies Tag Number
NASPHV Form #50
Owner's Name & Address - Use ball point pen or type
PRINT - Last r Tel
No. q I t Stre... City 13 P
ApoI7 Sex: Age: Size: P360 na t Breed: ,Colors:
Dog Male QI 3 mo. to 12 ma. C] Under 20 lbs. 0 01 e- CrN,f i:Srt(ilcur
Cat 0 Female 12 mo or older.. 20-50 lbs.
Name 1f2, Over 50 lbs. fl it it
Vacc. Serial (lot) No.
Producer: 1 yr. LIc.Nacc. Gqi 31 2,(42_
(First 3 letters) 'N'a 3 yr. Lic.Neco. Other
For Licensing Agency Use DATE VACCINATED: Veterinarian's: #
J 'License No.
Month Day Year
Signature
Other VACCINATION EXPIRES:
a VETE.7.:N.4 T-
Change U Add
Control No. 24090 W. EV..
Month Day
RABIES VACCINATION CERTIFICATE Rabies Tag Number
NASPHV Form #50
Owner's Name & Address Print - use bail point pen or type
PRINT - Last I Fl Te lett
No' t 31 ill Sire e t Zi
0,1,e
Species: Sex: Age: Size: Pregrominant Breed:
Dog R Male U 3 mo. to 12 mo.12‘ Under 20 lbs. pide Cr6-
Cat 0 FemaleR 12 mo. or older 20-50 ihs.
Name C antrY\ C-t Over 50 lbs.
aco. Serial (lot) No.
Producer: V. 1 yr. LIc./Vacc.
(First 3 letters) 0 3 yr. LIc.Nacc. Other
For Licensing Agency Use DATE VACCINATED: Veterinarian's: # 93
License No, Year LIcentlirNo.
Month Day Year '
si§natur-e
Other VACCINATION EXPIRES:
Change 0 Add 0 VETERINARY SEMI(
Control No. La Lei 40. 24090 W.HWY C15
Month Day Year .413101 :
RABIES VACCINATION CERTIFICATE Rabies Tag Number
NASPHV Form #50
Owner's Name & Address Print - use ball point pen or type _
PAINT -L t •f c‘First Ta
No.. ‘S reet C / :. Zijacc_.-
p- *it A 10 f 4..6 •.. 3
Spe lea: Sex: Age: Size: L. redominant Breed: Colors:
Dog ‘Ii4 Male 0. 3 mo. to 12 ma. 0 Under 20 lbs. 0 ad .e.._ € nj -
Cat 0 Female ASI 12 mo. or older N. 20-50 lbs. 0 ex , It AZ
Name e .c.,, k 'Z. [ 6, fl_-- Over 50 lbs. Vi. kfi tel qe il
Vacc. Serial (lot) No.
Producer: -4---1 1 ,g1 1 yr. Lio.Nacc.
(First 3 letters) al, 3 yr. Lic.Nacc. Other S' qi :3 a Co
For Licensing Agency Use DATE VACCINATED: Veterinarian's: #
License No. Year Lo. -73, ) .... Licerlso„NO.
Month Day Year r_
Signature
Other VACCINATION EXPIRES: .
Change 0 Add U I - VETERW.ARYSERVIC1
Control No. ...C1 3 s 24090 W. EiNY., 85
Month Day Year ) s RUCMSII-Ba A% 85823