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Maricopa County Animal Care And Control 2600 South 27th Avenue Phoenix, AZ 85009 (602) 506-7387 Tele. (602) 506-2739 Fax KENNEL PERMIT APPLICATION New El Renewal Permit # K os-&-' Name: r?-/S. Cif 14a1 Kennel Name: 4)1 ct-Of Si/loco 0 oejs Mailing Addressq 641 g, 2) id hors e r Kennel Location 6'1 E,kalcHuisv Dr. Cit A- ZIP County Supervisorial District l Kennel Phone: 11510 (543D 1;5 6 6 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. §11-1008. PLEASE ANSWER THE FOLLOWING QUESTIONS AND INITIAL EACH RESPONSE 1. 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.-44 I/We certify that 1/We have dogs and that the kennel meets the definition in statute. 49/ 3. i-;/--"v l/We certify that INVe 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 /We certify that INVe are submitting a valid copy of the rabies vaccination certificate for each dog with this application. 6. J.frrt I/We understand that a dog remaining within the kennel is not required to be licensed individually under A.R.S. § 11-1008. l/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. INVe 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. ,971 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. 7 1 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. INVe certify that all of the information I/We have provided is true and accurate under penalty of law. Applicant Signature Date: 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 and Control 2500 S. 27th Avenue Phoenix, AZ 85009-6797 (602) 506-7387 htto://pets.maricopa.gov Receipt Number: R14-184195 Receipt Date: 09/18/2014 Person ID: P2292456 Phone: 480 8206566 WI NGFOOT KENNELS 9/18/2014 10:34:37AM 964 E WILDHORSE DR CHANDLER, AZ 85286 Item: Animal ID: Reference No: Price: Each: Amount: KEN PERMIT A7777777 K15-000058 $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/MIX, TRICOLOR DOG License Information: Tag Number: License Expires: AnimaI# Vacc Date: Vacc Expires: Please retain this receipt with your pet's records APODACAP EBUSOFF Maricopa County Animal Care & Control 2500 South 27th Avenue Phoenix, AZ 85009 Phone: (602) 506-7387 pets.marieopa.gov KENNEL PERMIT PREMISE INSPECTION APPLICANT \ ectsa Or-04 STREET ADDRESS R(,L Pc cs.E. Dc-- CITY, STATE, ZIP Q_)\,(vA vxd\l'e r i 7_ 5-W4D PHONE ALTERNATE PHONE COUNTY DISTRICT I KENNEL LICENSE #1. NUMBER OF DOGS ii • Are all dogs over the age of three months properly vaccinated for rabies and in possession of a valid rabies vaccination certificate? Yes No NOTE: Copies of each rabies vaccination certificate must be attached to the Kennel Permit Premise Inspection form. 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 No 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.) Deputy Enforcement Agent Date )0- b- f Aashne Animal Hospital Dean L Kile, DVM 2860 S. Carriage Lane Mesa, AZ 85202 (480) 831-3031 Rabies Certificate Patient ID: 13950 Client ID: 2493 Patient Name: Bea Client Name: Teresa Smith Species: Canine Address: 964 E VVildhorse Dr Breed: Dachshund Sex: Spayed Female Chandler, AZ 85286 Color: Black/Tan Phone: (480)820-6566 Markings: Birthday: 05/29/2006 Weight: 19.00 pounds on 4/8/2011 Tag Number: 0 Vaccination Date: 9/11/2014 Lot Number: S311817A Expiration Date: 9111/2017 Producer: Pfizer K / MLV: Killed Virus Staff Name: Dean Kile, DVM License Number: AZ #1182 Tlt:1 ' Aashne Animal Hospital Dean L Kile, DVM 2860 S. Carriage Lane Mesa, AZ 85202 (480) 831-3031 Rabies Certificate Patient ID: 13952 Client ID: 2493 Patient Name: Cinnamon Client Name: Teresa Smith Species: Canine Address: 964 E Wildhorse Dr Breed: Dachshund Sex: Spayed Female Chandler, AZ 85286 Color: Red Phone: (480)820-6566 Markings: Birthday: 05/29/2006 Weight: 20.00 pounds on 4/812011 Tag Number: 0 Vaccination Date: 9/11/2014 Lot Number: S311817A Expiration Date: 9111/2017 Producer: Pfizer K / MLV: Killed Virus Staff Name: Dean Kile, DVM License Number: AZ #1182 Tig Nun Lot :Nun bc Aashne Animal Hospital Dean L Kile, DVM 2860 S. Carriage Lane Mesa, AZ 85202 (480) 831-3031 Rabies Certificate Patient ID: 1024 Client ID: 2493 Patient Name: Maggie Client Name: leresa Smith Species: Canine Address: 964 E Wildhorse Dr Breed: * Saluki Sex: Female Chandler, AZ 85286 Color: Tr-Color Phone: (480)820-6566 Markings: Birthday: 06/21/2009 Weight: 47.50 pounds on 10/9/2013 Tag Number: 0 Vaccination Date: 10/9/2013 Lot Number: S287243B Expiration Date: 10/9/2016 Pfizer K / MLV: Killed Virus Staff Name: Dean Kile, DVM License Number: AZ #1182,0:>" Aashne Animal Hospital Dean L Kile, DVM 2860 S. Carriage Lane Mesa, AZ 85202 (480) 831-3031 Rabies Certificate Patient ID: 1021 Client ID: 1031 Patient Name: Pal Client Name: • Hodge Address: 964 E Wild horse Dr Species: Canine 04- Breed: Saluki Sex: Female Chandler, AZ 85286 Color: Tr-Color Phone: Markings: Birthday: 06/21/2009 Weight: 39.00 pounds on 1/30/2014 Tag Number: 0 Vaccination Date: 10/9/2013 Lot Number: S287243B Expiration Date: 10/9/2016 Producer: Pfizer K 1 MLV: Killed Virus Staff Name: Dean Kile, DVM License Number: AZ #1182 Phoc; Aashne Animal Hospital Dean L Kile, DVM 2860 S. Carriage Lane Mesa, AZ 85202 (480) 831-3031 Rabies Certificate Patient ID: 3468 Client ID; • 2493 Patient Name: Asian iqtrnt . Name: Teresa Smith Species: Canine Address: 964 E Wildhorse Dr Breed: Saluki Sex: Male Chandler, AZ 85286 Color: Red Grizzle Phone: (480)820-6566 Markings: Birthday: 11/07/2013 Weight: 30.00 pounds on 3/8/2014 Tag Number: 0 Vaccination Date: 3/8/2014 Lot Number: S307864B Expiration Date: 318/2015 Producer: Pfizer K/ MLV: Killed Virus Staff Name: Dean Kile, DVM License Number: AZ #1182 Aashne Animal Hospital Dean L Kile, DVM 2860 S. Carriage Lane Mesa, AZ 85202 (480) 831-3031 Rabies Certificate Patient ID: 10149 Client ID: 1031 Patient Name: Autumn Client Name: Hodge Species: Canine Address: 964 E Wild horse Dr Breed: Saluki Sex: Spayed Female Chandler, AZ 85286 Color: Red Phone: Markings: Birthday: 03/29/2001 Weight: 42.00 pounds on 7/22/2014 „Tag iNumber: Vaccination Date: 3/31/2012 LOt Number: s165820c Expiration Date: 3/31/2015 Producer: Pfizer K / MLV: Killed Virus Staff Name: Dean Kile, DVM License Number: AZ #1182 , Aashne Animal Hospital Dean L Kile, DVM 2860 S. Carriage Lane Mesa, AZ 85202 (480) 831-3031 Rabies Certificate Patient ID: 2882 Client ID: 2493 Patient Name: Umay Client Name: Teresa Smith Species: Canine Address: 964 E Wildhorse Dr Breed: Shepherd, Anatolian Sex: Female Chandler, AZ 85286 Color: Fawn Phone: (480)820-6566 Markings: Birthday: 07/29/2012 Weight: 81.00 pounds on 12/14/2013 Tag Number: 0 Vaccination Date: 12/14/2013 Lot Number: S301989D Expiration Date: 12/14/2016 Producer: Pfizer K / MLV: Killed Virus Cl ir-i f AD: Staff Name: Dean Kile, DVM License Number: AZ #1182 sh, Aashne Animal Hospital Dean L Kile, DVM 2860 S. Carriage Lane Mesa, AZ 85202 (480) 831-3031 Rabies Certificate Patient 1D: 1022 Client ; ...• ID . . 2493 Patient Name: Einstein Client Name: Teresa Smith Species: Canine Address: 964 E Wildhorse Dr Breed: Saluki Sex: Male Chandler, AZ 85286 Color: Tr-Color Phone: (480)820-6566 Markings: Birthday: 06/21/2009 Weight: 55.00 pounds on 1/30/2014 Tag Number: 0 Vaccination Date: 10/9/2013 Lot Number: S287243B Expiration Date: 10/9/2016 Producer: Pfizer K / MLV: Killed Virus Staff Name: Dean Kile, D M License Number: AZ #1182 Aashne Animal Hospital Dean L Kile, DVM 2860 S. Carriage Lane Mesa, AZ 85202 (480) 831-3031 Rabies Certificate Patient ID: 1025 Client ID 2493 Patient Name: Zira Client'Name: Teresa Smith Species: Canine Address: 964 E Wildhorse Dr Breed: Saluki Sex: Female Chandler, AZ 85286 Color: Tr-Color Phone: (480)820-6566 Markings: Birthday: 06/21/2009 Weight: 46.00 pounds on 10/9/2013 Tag Number: 0 Vaccination Date: 10/9/2013 Lot Number: S287243B Expiration Date: 10/9/2016 Producer: Pfizer K / MLV: Killed Virus Staff Name: Dean Kile, DVM License Number: AZ #1182 Aashne Animal Hospital Dean L Kile, DVM 2860 S. Carriage Lane Mesa, AZ 85202 (480) 831-3031 Rabies Certificate Patient ID: 217 Client ID: 2493 Patient Name: Titan Client Name: Teresa Smith Species: Canine Address: 964 E Wildhorse Dr Breed: Saluki Sex: Male Chandler, AZ 85286 Color: Brwn/ Blk Phone: (480)820-6566 Markings: Birthday: 04/10/2008 Weight: 55.00 pounds on 10/9/2013 Tag Number: 0 Vaccination Date: 10/9/2013 Lot Number: S287243B Expiration Date: 10/9/2016 Producer: Pfizer K / MLV: Killed Virus Staff Name: Dean Kite, DVM License Number: AZ #1182 Aashne Animal Hospital Dean L Kile, DVM 2860 S. Carriage Lane Mesa, AZ 85202 (480) 831-3031 Rabies Certificate Patient ID: 13955 Client ID: 2493 Patient Name: Mrs.White Client Name: Teresa Smith Species: Canine Address: 964 E Wildhorse Dr Breed: Saluki Sex: Spayed Female Chandler, AZ 85286 Color: Cream Phone: (480)820-6566 Markings: Birthday: 09/01/2003 Weight: 39.00 pounds on 5/23/2014 Tag Number: 0 Vaccination Date: 9/11/2014 Lot_Number: S311817A Expiration Date: 9/11/2017 Producer: Pfizer -K,LVILV Killed Virus \cYi- Staff Name: Dean Kile, DVM License Number: AZ #1182 11:)' Producor: