KENNEL PERMIT RENEWAL FOR LINDA SHIVELY DBA EAST VALLEY RESCUE.PDF

Maricopa County

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

(602) 506-2739 Fax

KENNEL PERMIT

K22- 000 oo

APPLICATION

01 New cf Renewal
Name: A_s udp FY a Lv olf Kennel ame Knst ally bv eavk.
, 4 oo et pel
Mailing Address: g 125 ES Arve Kennel Address: C7) 24 ESA ve,
city: 7 Ved. /4f_State: AZ zip LSA26/ city Hea A Zip: We 20S/
County Supervisorial District: OL
Phone: LO ~ /] SIP-S Ge oO Kennel Phone: Y 46) PEYP-S TC D
F035 e375

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 foreach 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. 2 4 Ne 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).

art ti Bs certify that I/We have LZ ») dogs and that the kennel meets the definition in statute.
3. y hile certify that I/We have not been convicted of a violation of A.R.S. §§ 43-2910 (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).
4A 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.

/ We certify that We are submitting a valid copy of the rabies vaccination certificate for each

dog with thjs application.
wh he understand that a dog remaining within the kennel is not required to be licensed individually under
ARS. § 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.
GL de le 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.

: id 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..

6. de 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.

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

Applicant a 4 Merchy Date: adigahE he / yo

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 and Control

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

(602) 506-7387
http://pets.maricopa.gov

Receipt Number: R21-652568

E VALLEY RESCU KENNELS
8125 E 5TH AVE

MESA, AZ 85208

Receipt Date: 10/11/2021

Person ID: P0858375
Phone: 480 9845960

10/11/2021 11:43:03AN

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

Payments: Cash:
Check: $350.00

Credit Card:
Total Payments Received: $350.00

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

Want To and Contact MCACC" to email your comments for our
review.

Pet Licensed/Registered To:

tasakac WBUSOFF

Maricopa County
Animal Care & Control

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

KENNEL PERMIT K22-000009

PREMISE INSPECTION
Number of Dogs:10

Name Linda Shively Kennel Name: East Valley Rescue
Mailing Address:8125 E 5" Ave Kennel Address: 8125 E 5" Ave

City: Mesa State: AZ Zip: 85208City: Mesa State: AZ Zip: 85208
County Supervisorial District: 2

Phone: 480-984-5960 Kennel Phone: 480-984-5960

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 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 & Badge #: Lt. Chris Kunszt #3 Date: jou /2}

October 2015

4

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