Fillable Dog Friendly Patio Permit Application (Maricopa County Telecommunications)

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Dog Friendly Patio Permit Application (Maricopa County Telecommunications)

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The Dog Friendly Patio Permit Application (Maricopa County Telecommunications) form is 2 pages long and contains:

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  • 1 check-box
  • 16 other fields

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File type: PDF

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Maricopa County Environmental Services Department
Environmental Health Permitting Services Program
Phone: (602)506-6824
esplanreview@maricopa.gov
esd.maricopa.gov
http://www.maricopa.gov/2505/Locations-Hours
Dog Friendly Patio Permit Application
Page 1 of 2
The following application should be completed and returned to this Department prior to operating a Dog Friendly
Patio. Approval of a Dog Friendly Patio permit will be given upon completion of a Department conducted inspection
for compliance with the requirements of the Maricopa County Environmental Health Code, Chapter. VIII, § 2,
Regulation 4 and U.S. FDA 2013 Food Code § 6-501.115.
Dog Friendly Patio Regulations
Please review Regulation 4. Dog Friendly Patio
Business Name Permit # (if applicable)
Name
Address
City State Zip Code
Animal Entrance
to Patio
Briefly document what measures are being taken to address the following issues/concerns:
Signage
Email
Phone Number
Date
Disclaimer: Information entered on this form will be retained by Maricopa Environmental Services Department and is
a record as defined by Arizona law. This form will be provided without redaction in response to a public record request
unless any of the information is exempt from release under Arizona law.
Signature
ACKNOWLEDGEMENTS & DISCLAIMERS
I hereby certify that the above information is correct. I have provided all relevant material requested on the application.
I understand submitting this application does not guarantee my application will be approved. I understand that if the
Dog Friendly Patio permit is approved, failure to follow the submitted procedures will result in a violation against my
operating permit and repeated violations may result in action initiated by the Department to withdraw permission for a
dog friendly patio. By checking the check box and typing your name you have digitally signed this application.
I agree the application is true and correct.
Patio
Construction &
Cleaning
Procedures:
Dog Friendly
Chemicals
Being Used:
Food/Drink
Preparation &
Prevention of
Cross-
Contamination
Page 2 of 2
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Dog Friendly Patio Permit Application (Maricopa County Telecommunications)

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Completed 6 August 2020

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