2020.12.09 KENNEL PERMIT RENEWAL FOR ARTHUR MCKAY DBA HARQUAHALA KENNELS.PDF

Maricopa County

Animal Care and Control
2500 South 27th Avenue
Phoenix, AZ 85009
(602) 506-7387 Tele.

(602) 506-2739 Fax

KENNEL PERMIT

APPLICATION
O New of Renewal Ka\-O000\8
Name: A ethy .), Ne Kine / Kennel Name: //¢i¥Sv" babs enw ig

Mailing Address: (/O/,0a 5°34 Ave. Kennel Address: /V02 8-546 Aue -

City: OvggrH State: AZ Zip:_£S 307-79 So Citysc0 voOp4a bh A, Zip: {SFU 7239

County Supervisorial District: 5

Phone: (72-2 279 4623 Kennel Phone: 99 272 22-02

Please complete and sign this application and return it to the above address with payment in the amount of three
hundred fifty dollars ($350.00) 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 $6 per month for unaltered dog and $3 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

1. IWe assume complete responsibility for the kennel at the premises for which I/we are making
plication 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 ~ We certify that /We have___ 5 dogs and that the kennel meets the definition in statute.

3.2 We certify that I/We have not been convicted of a violation of A.R.S. §§ 13-2910 (cruelty to animals)
or 73-2910.01 (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. ae 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. | We certify that [We are submitting a valid copy of the rabies vaccination certificate for each
dog with this application.

6.02 We understand that a co~ 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.

1.2 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. @4,~|We understand that a person who knowingly fails to obtain a kennel permit within thirty days after
writtel notification from the county enforcement agent is guilty of a class 2 misdemeanor..

94 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.

UWe certify that all of the information I/We have provided is true and accurate under penalty of law.

Applicant Signature Chitin donre fea Date:_© ap) r/do0a 2

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

2500 S. 27th Avenue
Phoenix, AZ 85009-6797

(602) 506-7387

Receipt Number: R20-100236

HARQUAHALA KENNELS
10602 S 540TH AVE

TONOPAH, AZ 85354

and Conirol

http://pets.maricopa.gov

Receipt Date: 03/11/2020

Person ID: P0610901
Phone: 928 3722262

3/11/2020 3:54:44PM

Item: Animal ID: Reference No: Price: Each: Amount:
KEN PERMIT A7777777 K20-000018 $350.00 1 $350.00
Total Fees Due: $350.00

Payments: Cash:
Check: $350.00

Credit Card:
Total Payments Received: $350.00

Would you like to share your experience with our service to you? Thank You!
Please visit our website at http://pets.maricopa.gov and click on "I Change: $0.00
Want To and Contact MCACC" to email your comments for our : ‘

review: Balance Due: $0.00

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

johnsonk WBUSOFF

Maricopa County
Animal Care & Control

2500 South 27" Avenue
Phoenix, AZ 85009
Phone: (602) 506-7387
pets.maricopa.gov

KENNEL PERMIT K20-000018

PREMISE INSPECTION

Number of Dogs: 5

Name: Arthur McKay Kennel Name: Harquahala Kennels
Mailing Address: 10602 S 540" Ave Kennel Address:10602 S 540" Ave
City: Tonopah State: AZ Zip: 85354 City: Tonopah Zip: 85354

County Supervisorial District: 5

Phone: 623-399-3623 Kennel Phone: 928-372-2262

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.)

This is a RENEWAL application.
This premises was inspected 9/30/20; there are FIVE dogs on the property that are all
vaccinated for rabies, as well as confined to the property in a suitable manner.

Deputy Enforcement Agent & Badge #: Romero #4
Date: 9/30/20

October 2015

RABIES VACCINATION CERTIFICATE
NASPHY Form 51

Owner's Name & Address PRINT - use ballpoint pen or type

[ Rabies Tag Number

Dog 1 Male (1 | 3mo.-12mo. Under 20 Ibs.

Filey —_ hrelhwe "1023 39%

Cat | Female [] | 12mo.or older YP 20 - 50 Ibs. vg cars /shep Bown

Other [] | Neutered 1] Over 50 Ibs. (] | NAME:
Please specify >
DATE VACCINATED: VETERINARIAN

10 PRODUCER: P Fiz iT sth
10. mal Veteri Y (earanyen
Month Day Year (First 3 letters) License No.

saan’

VACCINATION EXPIRES: | yr.Lic./ Vaccine [] 4

i it ia Veterinarian’s
3 yr. Lic. / Vaccine
% — 2 2 m Signature

Month Day’ Year Pu Dole. in <) X12
Vaccine Serial (Lot) No. Wy

REQ _ INE X5

RABIES VACCINATION CERTIFICATE
NASPHV Form 51
Owner’s Name & Address PRINT - use ballpoint pen or type

lay. \elhuc

Rabies Tag Number

Telephone

(9933193b28

Please specify

Dusir

No. shhet City A Ae *y 538 U
lobo2 S-_ 410 Ave. “Tone pa
SPECIES: [SEX: SIZE: PREDOMINANT BREED: LORS)
Dog Mae O eae 12 mo. [1 | Under 20 tbs. 2] {
- 50 Ibs.
cat 1) | Female 12. mo. or older RA} 20 - 50
Other 1] | Neutered Over 50 Ibs. 1 (NAME: Ww)

7
DATE VACCINATED: VETERINARIAN

,
Month Day” Year

(First 3 letters) 4aad

3% By 14 PRODUCER: | Z — by 10) ct

License No.

VACCINATION EXPIRES: lyr Lic./Vaccine 1 Yesinarne
3 yr: Lic. Vaccine

AN = a

ore! Quatore. | sia? 2 Baxi

Na RRD A

RABIES VACCINATION CERTIFICATE
NASPHY Form 51

Owner’s Name & Address PRINT - use ballpoint pen or type

Rabies Tag Number

Dog [] Male 0) | 3mo-12mo. £1] | Under 20 Ibs. l.
Cat | Female GA] 12mo.or older] 20-50 Ibs. R27 \

Mekay. Ae{huue “1023994 Sua
\Wo2” ®. QYe hye “Tong h Az | 33354

EDOMINANT BREED: COLORS:

Other [1 | Neutered [1] Over 50 Ibs. CO [NaMeE:
Please specify ; vi} ‘
1 pper
DATE VACCINATED: VETERINARIAN
3 LU 19 PRODUCER: P F2i|.
; r Ee Veterinarian’s #:
~Month — Day Year

VACCINATION EXPIRES: | yr. Lic. /Vaccine []

(First 3 letters) bn 1 jets. No.

~ Li i VeterinaiQag
3 2 3 yr. Lic./Vaccine [E~ wae

Month Day” Year Q Yy : 210 | (@ Adresse} >
Vaccine Serial (Lot) No. Aree ne

VACCIN,
RABIES VACCINATION CERTIFICATE Tagfee$:_ : fv Ui in 4 Y
ADAPTED NASPHV FORM 51 Tag #: ha
— “ABIES
Owner’s Name & Address PRINT - use ball point pen or type Cert. Serial #:
a ‘COLYME DISEASE
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STREEr Ae ap - OCANINE PARAINFLUENZA
‘ss A&M COCANINE ADENOVIRUS 2
SPECIES; SEX: SIZE: DOMINANT BREED: | COLORS: COCANINE PARVOVIRUS
Dog Male O}3 vi to 12 Mo. (]} Under 20 Ibs. 0 x ns | \4f Be OI CANINE CORONAVIRUS
Cat Female 12 Mo. or older 20-50lbs O]| ¢ COCANINE BORDETELLA
Oth NAME:
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(Specify) i n La A OOFELINE LEUKEMIA VIRUS
: : FELINE PANLI E
DATE VACCINATED: PRODUCER: \eterinaarnes 4TAD OCUFELINE PANLEUKOPENIA

Month Year

Day

“ta, EXPIRES:

Month Day Year

1 yr. Lic./Vace.

3 ye Lea) Y ( 3A

License No.

ae

OOFELINE RHINOTRACHEITIS
OFELINE CALICIVIRUS

(First 3 Letters)

OFELINE CHLAMYDIA

CFELINE IMMUNODEFICIENCY
VIRUS

Vacc. Serial (Lot) No.

Boehringer

VAC0410001

Ingelheim

VACCI ION RECORD
RABIES VACCINATION CERTIFICATE Tag fee $: Name
ADAPTED NASPHV FORM 51 Tag #: BIES
Owner's Name & Address PRINT - use ball point pen or type Cert. Serial #: LYME DISEASE
ic leaw™ Poth." a7 apyp Souneseow
pA | COCANINE PARAINFLUENZA
NO, ee gl cr STATE ZIP
Lolo + CU 0) Bye! [ Lap al pate CICANINE ADENOVIRUS 2
SPECIES: se Oa. AGE: SIZE: gpa. BREED: | CQLORS: COCANINE PARVOVIRUS
Dog Male Mo. to 12 Mo. C1 Under 20 Ibs. 0 Wrep "4 B { ) ix } CICANINE CORONAVIRUS
cat( O Female 5 12 Mo. or older 20 - 50 Ibs OOCANINE BORDETELLA
NAME:
Othe O Altered Over 50 Ibs\ Mi b COLEPTOSPIROSIS
Specity) TAL DA, CIFELINE LEUKEMIA VIRUS
7 OO FELINE PANLEUKOPENIA
E VARCINATED; lam PRODUCER: Veterinarian’s # AG >)
{ AT V f- icense No! OFELINE RHINOTRACHEITIS
Month Day ‘Year rst 3\Letters OFELINE CALICIVIRUS
COFELINE CHLAMYDIA
1 yr. Lic. Vace. 0) i zi
“fr iy ite ip i <= > CFELINE IMMUNODEFICIENCY
2 3 yr weNace. 2 & ‘4 ‘Address VIRUS
Month Day Year z COOKS UCKEYE YETERINA AD ¢ Oo
Vacc. Serial (Lot) No. 24090 W. Es Boehrin
- y x ger
_ BUCKEVE AY : 5 Ingelheim

VAC0410001