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Dog Friendly Patio Permit Application (Web Form)
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Dog Friendly Patio Permit Application
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
Alternate Phone Number
Briefly document what measures are being taken to address the following issues/concerns:
Animal Entrance to Patio:
Food/Drink Preparation & Prevention of Cross-Contamination:
Patio Construction & Cleaning Procedures:
Dog Friendly Chemicals Being Used:
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.
Electronic Signature Agreement
By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.
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.
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