Loading...
NCITY OF BLAIR - 29 VT LICENSE %A L-fCA(i!! 06r If you live in Blair City limits and own a clog(s) and/or cat(s), complete this form and return with check made payable to: City of Blair a 218 8 16th 8t e Blair, NE 68008 You may legally own a -combination of four (4) adult pets, but no more than three (3) adult dogs or three (3) adult cats per residential or dwelling unit. LICENSE RENEWALS ARE DUE: I rch 15, 2022 OwnerName: ''/`) C �� Owner Address: City/State/Zip: Blair, NE 680108 Phone # � ° 1 v 6/ — � �� LICENSE FEES: Dog or Cat: $16.00 Altered Dog or Cat: $11.00 ***PLEASE READ CAREFULLY*** YOU ARE REQUIRED BY LAW TO LICENSE YOUR PETS. Failure to do so is a violation of City ordinances 6.103 and carries a penalty of a fine up to $150.00 per pet. PET LICENSES RENEWALS ARE DUE BY 3/15/2022. The City shall recognize a microchip identification number as the license number. It shall be unlawful for any dog or cat to wear any license or other city Identification other than that Issued by the City of Blair for such dog or cat. The City of Blair requires proof of rabies vaccination. Replacement Fee for Lost Tag: $5.00 Included is a State Fee of $1.25 being collected to fund the Nebraska Dog & Cat Operator Inspection Program PET # 2 ❑ Dog ❑ Cat ❑ Spayed/Neutered Pet Name Birthdate Sex Color Breed** Declared Dangerous or Potentially Dangerous Dog: ❑ Y MICROCHIP # (If applicable) RABIES VACCINATION DATE: (3 yr) _ M (1 yr) License Fee $ Replacement $ * * q• r PET #3 ❑ Dog ❑ Cat ❑ Spayed/Neutered License Fee $ Pet Name Birthdate Sex Color Breed** Replacement$ _ ** Declared Dangerous or Potentially Dangerous Dog: ❑ Y ❑ N MICROCHIP # (If applicable) SUBTOTAL: $ RABIES VACCINATION DATE: (3 yr) (1 yr) City Tag # *PLEASE INCLUDE THE CITY TAG NUMBER IF THIS IS A RENEWAL ** (This fee is due along with License Fee if requesting at the time of license renewal.) Do Not Send Cash by Mail TOTAL ENCLOSE® If you have, questions, please contact Blair Police Department at (402) 426-4747 ++++++.....++.+++.....+++.++....+++++..+.+++++.+++..... -....++++++.....++++.++ NEW PET/NEW RESIDENT LICENSING REQUIREMENTS (March 15late fee date not applicable fornewpets/newresldents) Newly Acquired Pets: New Residents to Blair: • Must be licensed within 10 days of ownership N Must register pets within 10 days of • <OR> at 6 months of age if puppy/kitten residency. 03/08/2022 15:01 4024260101 HOLSTEIN VET CLINIC PAGE 01/01 BUT N it shall be uni 2022 PET LICENSE ERI,FICATION/APPLICATION FOR CITY OF BLAIR IF YOU LIVE IN BLAIR CITY LIMITS AND OWN A DOG(S) AND /OR CAT(S), HECK PAYARLE TO' COMPLETE THIS FORM AND RETURN WITH A C CITY OF GLAIR — 218 S. 16" ST — BLAIR, NE 68008 you MAY LEGALLY OWN A COMBINATION OF FOUR (4) ADULT PETS, MORE THAN THREE (3) ADULT DOGS OR THREE (3) ADULT CATS PER RESIDENTIAL OR DWELLING UNIT. ***PLEASE READ CAREFULLY*** %RE REARED BY LAW TO LICENSE YOiJR PETS, THE �iTY OF BLAIR RECIUIRE� PROOF OF RABIES VAGGINt, Failure to do so is a violation of City Ordinances 6a0a and carries a penalty of a fine up to $150,00 per pet, PET LICENSE RENEWALS ARE DUE BY 3 15 202L The city shall recognize a microchip ID number as the license number. I for any dog or cat to wear any license or other city ID other than that issued by the City of Blair for such dog or cat; ING Must be licensed within 10 days of ownership (OR) at 6 months of age if puppy or kitten TO BLAIR Must register pets within 10 days of residency Owner Nam i Darlene Nazarian Spouse Terence i Owner Add * ss 786 N 10th St. City/State/ ;p • Blair, NE 68008 I ' Phone # 402-999-3871 I ff Pet Name: ( eves Age: 4Y Sex.: Spayed Female color:\, Toni DOB:—04-01; 7 Breed: Do stic Shorthair Microchip # 1985112008953721 Rabies Tag # Pi__EASE INCLUDE CITY TAG NUMBER IF THIS IS A RENEWAL (IF AVAILABLE): # RABIES VA INATION DONE ON 03.08-22 i Rabies Descirlption: YEARS 3 YEAR i i I i i Hol stein Veterinary Clinic Dr. Lis ' Schrum DVM : Dr. Krlsta HOlstein DVIV 718 blouth 191h Street Blair, NI; 68008 24 - 26-7387 402-426-0101 Fax holsteinclln ' ic@ ma il.com g I LICE SN E FEES Intact Dog or Cat: $16.00 Alter D g or cat: $11 0 Replacement rag $5.00 (' l Total $ PFTS THAT AR ON THE AC VE POTENTI4LLY DAN RODS OR DANrEROUS DOG LIST NEED TO REGIST[i(>: AIREGTLYAT CITY HALL FAXED 03-08-22 BY .,r���+R!�'!.!1� `�';\:,�'Lil,�i'Ba��i!.'. �';'fl'•,. ,.,;2n"�'�.Q.�II�^�!�!F^!!L!'!u'',�:� , � 7 )i.fi2 , 1 i.:• i�:ii ' ni�"fY :�i�.i.6L,`.;; j•i� i .; �y �;�•��:ii:. :7 : N�O:j� ..bpi:': � ��l !•r.,��,. �:�i!(i'ri�i ISi {1;;2�,'<❑; I:';'','�":a i..,�„i�l'l 'I �; �'� '� VM:�; A� i'4 'iT �N ��rn a.. ! G::a1, � y�.. �� L:o�od; n.i �, ,S.e:s rya • rya.¢: i'.Y CITY OF BLAIR - 20�2�2 �E�T LXCEVN"S'QE(_AP�`P�Lli � T(�iO If you live in Blair City limits and own a dog(s) and/or cat(s), complete this form and return with check made payable to: City of Blair 9 218 S 16th St a Blair, NE 68008 You may legally Own a combination of four (4) adult pets; but no more than three-(3) adult dogs or three (3) adult cats per residential or dwelling unit. LICENSE RENEWALS AREDUE: March 15, 2022 Owner Name:: , Owner Address: City/State/Zip: Blair, NE 68008 Phone # ***PLEASE READ CAREFULLY*** YOU ARE REQUIRED BY LAW TO LICENSE YOUR PETS. Failure to do so is a violation of City ordinances 6.103 and carries a penalty of a fine up to $150.00 per pet. PET LICENSES RENEWALS ARE DUE BY 3/1512022. The City shall recognize a microchip Identification number as the license number. It shall be unlawful for any dog or cat to wear any license or other city Identification other than that Issued by the City of Blair for such dog or cat. The City of Blair requires proof of rabies vaccination. LICENSE FEES: Dog or Cat: $16.00 L� Altered Dog or Cat: $11.00 Replacement Fee for Lost Tag: $5.00 Included is a State Fee of $1.25 being collected to fund the Nebraska Dog & Cat operator Inspection Program t Vj 11 0,1 t .k Dog ® Cat Spayed/Neutered License Fee $ 1 , ,. Pet Name Birthdate Sex9 . olor Breed**Replacement$ eclared Dangerous or Potentially Dangerous Dog: ® Y ,Q N, MICROCHIP # (If applicable) SUBTOTAL: RABIES VACCINATION DATE: (3 yr) L— (I yr) ,CitV Tag # , PET 2, U Dog CI Cat U Spayed/Neutered License Fee $ t ; ti` Pet Namet v Birthdate - - Sex , : r , , Color ;�� Breed** Replacement $ Declared Dangerous or Potentially Dangerous Dog: ® Y El N MICROCHIP # (If applicable) SUBTOTAL: $ RABIES VACCINATION DATE:_ (3 yr) (I yr) City Tag # ` ET #3 C4 Dog Ll Cat ® Spayed/Neutered !.License Fee -Pet Name Birthdate _ Sex Color Breed** _ ^ Replacement $ ** Declared Dangerous or Potentially Dangerous Dog: Ll Y ® N MICROCHIP # : (If applicable) SUBTOTAL: $ RABIES VACCINATION DATE: (3 yr) (1 yr) City `fag #` *PLEASE INCLUDE THE CITY TAG NUMBER IF THIS IS A RENEWAL ** (This fee is due along with License Fee if requesting at the time of license renewal,) Do Not Send Cash by Mail TOTAL ENCLOSED $ LLLLJ If you have questions, please contact Blair Police Department at (402) 426-4747 ..........•h.........-F..-F.^a^I-..........i...I-..................................... NEW PET/NEW RESIDENT LICENSING REQUIREMENTS (March 15/ate fee date not applicable for newpe&lnewresidents) Newly Acquired Pets: New Residents to Blair: IM Must be licensed within 10 days of ownership N Must register pets within 10 days of <OR> at 6 months of age if puppy/kitten residency. AD ,.,0r21/2022 11:23 4024260101 HOLSTEIN VET CLINIC PAGE 01104 2022 PET LICENSE VERIFICA`i"ION/APPLICATION FOR CITY OF BLAIR IF YOU LIVE IN BLAIR CITY LIMi'T5 AND OWN A DOG(S) AND /OR CAT(Sj, COMPLETE THIS FORM AND RETURN WIi`l-I A CHECK PAYABLE TO: CITY OF BLAIR -^ 218 S. 16TH BT — BLAIR, NE 68008 YOU MAY LEGALLY OWN A COMBINATION OF FOUR (4) ADULT PETS, BUT NO MORE THAN THREE (�) ADULT DOGS OR THREE (3) ADULT CATS PER RESIDENTIAL OR DWELLING UNIT. ***PLEASE READ CAREFULLY**' YOU ARE REQUIRED BY LAW TO LIGEN E YOUR PETS. THE CITY OF BLAIR RC 1!I PROOF OF RABIES VACCINAIyc1N. Failure to do so is a violation of City Ordinances 6,103 and carries a Pei)alty of a fine up to $150,00 per pot. PET LICENSE RENEWA ARE DUE BY 3 15 2022. The city shall recognize a microchip la number as the license number. It shall be unlawful for any dog or cat t4 wear any license or other city !a other than that issued by the City of Blair for such dog or cat, NEW PET LICENSING Must be licensed within 10 days of ownership (OR) at 6 months of age if puppy or kitten NEW RESIDENTS TO GLAIR Must register pets within 10 days of residency Owner Name Amanda Nelson Spouse Owner Address) 1123 N 17th Ave'. City/Statel�ip Blair, NE 68008 Phone # 402-651-2079 Pet Narn$; Lyra Age: 5Y DOB: 04-11.17 Sex: Spayed Female Color: Gold Breed: Goldendoodle Kcrochip # 985112008180482 Rabies Tag # 18184 w PLEASE INCLUDE CI'T`Y' TAG NUMBER IF THIS IS A RENEWAL. (IF AVAILABLE): # RABIES VACCINATION DONE ON 05.25-21 Rabies Description: '� YEAR =;YEAR I i l--Iolstein Veterinary Clinic Dr Lisa Schrum DVM . Dr. Kristo Holstein DIAM 718 South 191h Street glair, NE,6800$ 402-426-7387 402-426-0101 rax holsteincli nie@ g mail,com LICENSE FEES Intact Dog or Cat: $1 GAO Replacement Tsgt $5.00 Total $ ` 0) PE1�3 THATARE UN iNEAC7lVE PDTEIViIAILY QAAfCaEROUS DR DANGEROUS DQ UST NEED TO REGISTER D1REC7LYAT 1TY 1.l. FAXFD 05-21-22 BY ,. q�rryu. �nij �. ,,i AA '� ,,pf•,f ihAa 1 hrX1;�1� �,`t' I• �i� �]T�y • Y 3'Y' 1 n.C�;l� Y-�.��1>l,'. 9 f}} 'r'£at:YgSYn, CITY OF BLAIR - 20 2 PET LICENSE AP L CAON if you live in Blair City limits and own a dog(s) and/or cat(s), complete this form and return with check made payable to: City of Blair e 218 S 16th St e Blair,, NE 68008 You may legally own a combination of four (4) adult pets, but no more than three (3) adult dogs or three (3) adult cats per residential or dwelling unit. LICENSE RENEWALS ARE DUE: March 15, 2022 ***PLEASE READ CAREFULLY*** Owner Name: Hkg s ii kt,#, �J LL �a t4 YOU ARE REQUIRED BY LAW TO LICENSE YOUR PETS, Owner Address: Failure to do so is a violation of City ordinances 6.103 and carries a penalty of a fine up to $150.00 per pet. city/state/zip: Blair, NE 68008 PET LICENSES RENEWALS ARE DUE BY 3/IS/202 . The City shall Phone # Cia �) 6 57- Z ;_3 recognize a microchip Identification number as the license number. it shall be unlawful for any dog or cat to wear any license or other city Identification other than that Issued by the City of Blair for such dog or cat. The City of Blair requires proof of rabies vaccination. LICENSE FEES: Dog or Cat: $16.00 Altered Dog or Cat: $11.00 Replacement Fee fur Lost Tack. $5.00 Included is a to Fee of $1.25 being collilcted tofund the Nebraska Dog & Cat Operator Inspection Program #1 W Dog Ll Cat � Soayed/Neutered License Fee $ 0 PZET Name Ak, C ie!Birthdate, Sex C� lor C1,�� B Replacement p�v reed** ius eclared Dangerous or Potentially Danger' Dog: LJ Y N \ j\4� e MICROCHIP # (If applicable) SUBTOTAL: $ 0 0 City Ta (3 yr) g VACCINATION DATE: A,4 /z 1 (1 yr) .1"RABIES - N _ PET #2 LJ Dog Ll Cat LJ Spaye'd/Neutered License Fee $ Pet Name Birthdate Sex " '-- i, Replacem Color Breed" ent $ ,oclared Dangerous or Potentially Dangerov.; Dog: LJ Y LJ N MICROCHIP # applicable) SUBTOTAL:$ �ABIES VACCINATION DATE: (3 yr) (1 yr) - City Tag # PET #3 LJ Dog LJ Cat LJ Spaye(l,/Neutered License Fee $ Pet Name Birthdate Sex Color Breed** Replacement Deciaied Dangerous or Potentially Dangprol_�', nog: u y U N� MICROCHIP # applicable) SUBTOTAL:$ RABIES VACCINATION DATE: City Tag # (3 yr) (1 yr) *PLEASE INCLUDE THE CITY TAG NUMBER IF THIS IS ARENEWAL (This fee is due along with License Fee if requesting at the time of license renewal.) Do Not Send Cash by Mail TOTALENCLOSED$ If you have questions, please ( Intact Blair Police Department at (402) 426-4747 ................................. ..................... II ....................... NEW PET/NEW RESIDENT LICENSING REQUIREM ITS (March 15 late fee date not applIcable for newke&lnew residents) Newly Acquired Pets: New Residents to Blair: * Must be lioensed within 10 .. days of ownership N Must register pets within 10 days of * <OR> at 6 months of age if puppy/kItten I residency. Thone Animal Hospital Patient Chart 902 S Hwy 30 Blair, NE 68008 402-426-3630 Printed: 01-15-22 at 9:49a CLIENT INFORMATION Name Marshal Nelson (4329) Address 2716 Sunrise Drive Spouse Lynda Blair, NE 68008 Phone 402 657-9232 Balance 0.00 PATIENT INFORMATION Name Jackson Species Canine Sex Male, Neutered Breed Rat Terrier Birthday 10-27-13 Age 8y ID Rabies 006619 Color Blk Brn Weight 19.00 lbs Reminded 04-01-21 Codes Al 02-11-20 8:13a: USE CAUTION - WILL BITE - TAKE TO BACK AND MUZZLE MEDICAL HISTORY Date By Code Description Qty (Variance) Photo 08-17-21 RXC SPCT2 Spectrum Green 8-25# 6 Give 1 tablet orally once every 30 days. 04-13-21 JRD THANK Thank You!!! COMPNT Complimentary Nail Trim R3 Rabies Vaccination (3 Year), #006619 2 DA2PPV+L 410012 Bordetella Injectable IVLSO Requisition 19898-674715 Test Result Flag Normal Range Measure Low High SNAP 04-13-21 9:00a AP_spp Negative EC-EE Negative HW Negative Lyme Negative 4DX Snap 4Dx Plus Test - Heartworm/Tick Test 57V Vaccination Exam 03-01-21 RXC SPCT2 Spectrum Green 8-25# 6 Give 1 tablet orally once every 30 days. 08-11-20 RXC SPCT2 Spectrum Green 8-25# 6 Give 1 tablet orally once every 30 days. 04-14-20 JRD THANK Thank You!!! COMPNT Complimentary Nail Trim Patient Chart for Jackson Date: 01-15-22, Time: 9:49a Date By Code Description 04-14-20 JRD 410012 Bordetella Injectable 2 DA2PPV+L 57V Vaccination Exam 02-11-20 JRD 58 Re Check 02-11-20 RXC SPCT2 Spectrum Green 8-25# #15715 Give 1 tablet orally once every 30 days. 10-18-19 JRD CARP25 Carprofen 25mg #14580 GIVE 1 TABLET BY MOUTH TWICE DAILY FOR 14 DAYS. CIP250 Ciprofloxacin 250mg #14579 GIVE 1/2 TABLET BY MOUTH TWICE DAILY FOR 14 DAYS. ZDISC Discount Per Dr HISI Histopathology IDEXX BUSTER Elizabethen Collar 125 Surgery Hospitalization SGM Surgical Monitoring 125A Naxcel Injection ONSIORIN Onsior inj/mL 6GROW Growth Removal AN1 Anesthesia <20 # IVLSO Requisition 19898-630924 Test Result Flag Normal Range Low High Catalyst —One 10-18-19 8:53a GLU 100 74 143 CREA 0.9 0.5 1.8 BUN 9 7 27 BUN/CREA 10 TP 7.0 5.2 8.2 ALB 3.3 2.3 4.0 GLOB 3.7 2.5 4.5 ALB/GLOB 0.9 ALT 122 10 125 ALKP 86 23 212 CH10 Chem10In-house 07-05-19 RXC SPCT2 Spectrum Green 8-25# #11543 Give 1 tablet orally once every 30 days. Client: Marshal Nelson Page: 2 Qty (Variance) Photo Measure mg/dL mg/dL mg/dL g/dL g/dL g/dL U/L U/L 28 14 M 06-07-19 JRD 8PRED1 Prednisolone 5mg #13128 6 Give 1/2 tablet orally twice daily for 3 days, then 1/2 tablet orally once daily for 3 days, then 1/2 tablet orally every other day for 3 days or until gone. 8AMOX3 Amoxicillin Caps 250mg #13127 14 Give 1 capsule orally twice daily for 7 days. 57 Examination 03-29-19 LL 1 Bordetella, PI3 (Intra-trac 3) AC6 Check up, DA2PPV+L Patient Chart for Jackson Date: 01-15-22, Time: 9:49a Date By Code Description Client: Marshal Nelson Page: 3 City (Variance) Photo 12-19-18 LL SPCT2 Spectrum Green 8-25# #11543 6 Give 1 tablet orally once every 30 days. 03-09-18 LL 222 Urinalysis R3 Rabies Vaccination (3 Year), #003942 AC6 Check up, DA2PPV+L 1 Bordetella, PI3 (Intra-trac 3) 06-16-17 LL SPCT2 Spectrum Green 8-25# 12 Give 1 tablet orally once every 30 days. 03-18-17 LL AC6 Check up, DA2PPV+L 1 Bordetella, P13 (Intra-trac 3) 05-10-16 LL 230 Spotchem II Prep Profile SGM Surgical Monitoring 6ANTI Antibiotic Injection FLUA Fluoride Applied AN1 Anesthesia <20 # DD1 Canine Teeth Cleaning (<20 Ibs) 03-05-16 LL 631 Heartguard to 25# each 12 1 Bordetella, PI3 (Intra-trac 3) AC10 Annual Checkup, DA2PPV 12-05-15 LL 8SIMP1 Simplicef Tabs 100mg Ea #5135 10 Give 1 tablet once daily until gone 202 CBC (Complete Blood Count) 125A Naxcel Injection 230 Spotchem II Prep Profile 57 Examination 02-06-15 LL AC10 Annual Checkup, DA2PPV 1 Bordetella, PI3 (Intra-trac 3) R3 Rabies Vaccination (3 Year), #001789 01-05-15 OTC 631 Heartguard to 25# each 12 04-17-14 LL 600056 Hernia Repair CRYPT/D Cryptorchid Surgery/Dog 03-14-14 LL SS Your Receptionist Is Stephanie AC10 Annual Checkup, DA2PPV R1 Rabies Vaccination (1 Year), #001260 -"7iSe 01 Q' Date: 01-11-2022 NC 0 L--K?,S 16 (A-T P(, j<,� . >L--J5 AITA C14P-ID ) 0 fO 4� -V'4' —(J,�A �< ( ( Dear Marshall Nelson, C(�TA Your payment in the amount of$ 21.00 (check #13266 for the 2022 Pet License) is being returned to you for one of the following reasons: Omitted signature. 2). Wrong fees submitted (Spayed/Neutered pet $11 .00 license fee per pet.) (Dog or Cat $16.00 license fee per pet.) **Fee includes $1.00 for the Nebraska Dog & Cat Operator Inspection Program" 3). XX Omitted proof of Rabies vaccination date for Jackson SUBMIT COPY OF RABIES VACCINATION REPORT 4). XX Other OMITTED PROOF OF SPAY OR NEUTER Please include the missing information and resubmit your payment. If you have any questions, feel free to contact us at 402-426-4191. Respectfully, City Hall 218 South 16th Street - Bla1r, Nebraska 68008 - 402-426-4191 - Fax 402-426-4195 o E-mall dtyofb1a1r9d,b1a1r,ne,us 04/01/2022 11:45 4024260101 HOLSTEIN VET CLINIC PACE ' 2022 PET LICENSE VERIFI ATION/APPLICATION FOR CITY OF BLAIR IF OU LIVE IN BLAIR CITY LIMITS AND OWN A DOGS) AND /OR CAT(S), COMPLETE THIS FORM AND RETURN WITH A CHECK PAYABLE TO: Cr Y OF BLAIR — 218 S. 16TH S'T — BLAIR, NE 68008 OU MAY LEGALLY OWN A COMBINATION OF FOUR (4) ADULT PETS, BUT NO MORE THAN T iREE (3) ADULT DOGS OR THREE (3) ADULT CADS PER RESIDENTIAL OR DWELLING UNIT. ***PLEASE READ CAREFULLY' YOU ARE REQUIRED B LAW TO LICEN YOUR Pi TS. T L CITY OF BL41 NEQUIRES PROOF OF RABIES VUCINATION. Fallure to dos 3 Is a violation of City Ordinances 6.103 and carries a penalty of a fine up to $150,00 per pet. PET LICENSE RENEWALS ARE DUE BY 3/35/2022 Thii city shall recognize a microchip ID number as the license number. It shall be unlawful for any dog or cat to wear any license or other city ID other than that issued by the City of Blair for such dog or cat. NEW PET LICENSING Must be licensed within 10 days of ownership (OR) at 6 months of age if puppy or kitten NEW RESIDENT$ TO BLAIR M st register pets within 10 days of residency Owner Name 1 11 Todd Nielsen Spouse Denise Owner Address 1104 South St City/State/Zip Blair, NE 68008 Phone # 402-237-0077 rat Name. Major Age: 1OY Se : Neutered DOB: 09-21-11 Breed: Poodle,Standard Color: Black Microchip # I Rabies Tag # 20222 PLEASE INCLUDE CITY TAG NUMBER IF THIS IS A RENEWAL (IF AVAILABLE): # RABIES VACCINATION DONE ON 104-01-22 Rabies Description: 11 YEAR Holstein Veterinary Clinic Dr. Lisa Schrum DVM Dr. KrisPa Holstein DVM 718 South 191h Str et Blair, NE 68008 402-426-7387 4 2-426-0101 Fax holsteinclini @grrlail,com LICE,N E FEES Intact Dog or Cat: $16.00 AtD Dog 0 Rep/acement Tap $5.00 Total $ "�,\ PETS THATARE ON THEACTIVE POTENTIALLY DANGEROUS OR FAXED 04-01-22 BY •i,WR••:bW���.,,�r�./' `"?. �;��mTiJ�r�!t' ry•�, i,lrinP:'. t!�;),� '+t°' ;ij :nr_ ..1,,.':a.ii ��..�4ii:n;ii;f �Urv,�,i .il"h: i/c:'r�:�. �:���� ' til!:,!!6.•;n.. •;'iris •„i '• :/.d i'.'f i:u, :',M1!(,. HOLSTEIN VET CLINIC PAGE 01/02 04/01/2022 •t 11:45 4024260101 VERIFI IF Cl' BUT NO MORE THAN 2022 PET LICENSE ;ATION/APPLICATION FOR CITY OF BLAIR OU LIVE IN BLAIR CITY LIMITS AND OWN A DOG(S) AND /OR CAT(S), COMPLETE THIS FORM AND RETURN WITH A CHECK PAYABLE TO: Ir OF BLAIR — 218 S. 46TH ST — BLAIR, NE 68008 OU MAY LEGALLY OWN A COMBINATION OF FOUR.(4) ADULT PETS, IREE (3) ADULT DOGS OR THREE (3) ADULT CATS PER RESIDENTIAL OR DWELLING UNIT, ***PLEASE READ CAREFULLY*** Failure to dos i is a violation of City Ordinances 6,103 and carries a penalty of a fine up to $150.00 per pet. . PET I,IGENSE RENEWALS ARIr DUE BY 3/15/2022. The city shall recognize a microchip ID number as the license number. It shall be unlawful for any dog or cat to wear any license or other city ID other than that issued by the City of Blair for such dog or cat. NEW PET LICENSING Must be licensed within 10 days of ownership (OR) at 6 months of age if puppy or kitten, NEW RESIDENTS TO BLAIR M ist register pets within 10 days of residency Owner Name Spouse Owner Address City/State/Zip Phone # Todd Nielson Denise •4• 1104 South St Blair, NE 68008 402-237-0077 rot Name: Saydee v w . Age; 7M DOB: 08�09-21 Se Spayed Female Color: Black Breed: Cane Corso Microchip # Rabies Tag # 20052 PLEASE INCLUDE CITY TAG NL MEN IF THIS IS A RENEWAL (IF AVAILABLE): # BABIES VACCINATION DON ON 01-21-22 Rabies Description: 1 YEAR 3 YEAR Holstein Veterinary Clinic Dr. Lisa Schrum DVM • Dr, Krista Ho/stein DVM 718 South 191h Street Blair, NE 68008 402-426-7387 02-426-0101 Pax hoisteinclinil@gmail.com LICENSE FEES Intact Dog or Cat: $16.00 tared Dog o cat: $11. 0 Replacement Tag $5.00 Total $ �� PETS THATARE ON THE ACTIVE POifNTIALW DANGEROUS 4R DANGEROUS DOG LIST NEED r0 RE6ISTER DIRECTLY AT CITY HALL, FAXED '04-01-22 BY . „1 . •,•r .••r,8'�:�;a. ^:.ItSb;: r..,..�r a:I •.i(.:v�,. ;. v---�^--,.�`1'Q�i: 7 �':i4`' p� � �,I• �l �I�'� � '�i� �!,� �. 1�1% �� (�j • ll%ifs • ,I'ir �', 1 !i�.ir:vL •i'r'. nn'�^t•„ yi': p ti lU^�gnMW�;AA5;,4r, tu,^ I• i i�,l'•��r�'pJ,J.. F' �iir.;';u"• f;,Ii,. '•'Y,Ia;�" i'�W!t :;tAt, •.. ��."A+ ��il;il�i li::':��l�,�ol(vra!•.m,.f •i r^.^Iti �' 1�i. �,�:' ���fJ;r-yt�y;. CITY OF BLAIR - 2022 PET LICENSE APPLICATION If you live in Blair City limits and own a dog(s) and/or cat(s), complete this form and return with check made payable to: City of Blair e 218 S 16th St o Blair,, NE 68008 You may legally Own a combination of four (4) adult pets,but no more than three,(3) adult dogs or three (3) adult cats per residential or dwelling unit., LICENSE RENEWALS ARE DUE: March 15, 2022 Owner Name:jc1 4,, Owner Address: 'I 12 -s C' 9"84,0 le city/state/zip- Blair, NE 68008 - 6 ), q L-2 ---, 974 -)-,7 Phone # - LICENSE FEES: Dog or Cat: $16-00 ***PLEASE READ CAREFULLY*** YOU ARE REQUIRED BY LAW TO LICENSE YOUR PETS, Failure to do so is a violation of City ordinances 6.103 and carries a penalty of a fine up to $150.00 per pet. PET LICENSES RENEWALS ARE DUE BY 3/15/2022. The City shall recognize a microchip Identification number as the license number. It shall be unlawful for any dog or cat to wear any license or other city Identification other than that Issued by the City of Blair for such dog or cat. The City of Blair requires proof of rabies vaccination. Replacement Fep for Lost Tag, $5.00 r Ir ..... ..... Pviiararri PET #1 Dog Ll Cat 4Spayed/Neutered License Fee$ Pet Name &r-e -e li'p N Birthdate /a.-9-17 Sex Color cAu.,K %-j'�4e, Breed** Replacement$ Declared Dangerous 6\, r Potentially Dangerous Dog: ®Y k 3 MICROCHIP _(If applicable) SUBTOTAL: $ RABIES VACCINATION DATE: (3 yr) (1 yr) _ City Tag #fp PET #2 Dog D Cat Spayed/Neutered License Fee $ Pet Name k Birthdate i,j�i *,)�.- I � Sex Colorer ,t,K-, Breed**ft.-,,,,,, n('r] — Rep cement $ Declared Dangerous or Potentially Dangerous Dog: 0 Y N MICROCHIP 1?3'4�- (If applicable) SUBTOTAL:$ RABIES VACCINATION DATE: 60-1 - 2, 0 - (3 yr) -�_ (I yr) -- City Tag PET #3 LJ Dog D Cat D Spayed/Neutered !.License Fee $ Pet Name Birthdate Sex Color Breed" Replacement$ Declared Dangerous or Potentially Dangerous Dog: D Y El N MICROCHIP# (If applicable) SUBTOTAL.- $ RABIES VACCINATION DATE: (3 yr) (1 yr) City Tag *PLEASE INCLUDE THE CITY TAG NUMBER IF THIS IS A RENEWAL ** (This fee is due along with License Fee if requesting at the time of license renewal.) Do Not Send Cash by Mail TOTAL ENCLOSED$ If you have questions, please contact Blair Police Department at (402) 426-4747 ......................................... I ..... 4 ................................ NEW PET/NEW RESIDENT LICENSING REQUIREMENTS (March 15 late fee date not applicable for newpet7lnew resldenly) Newly Acquired Pets: New Residents to Blair: w Must be licensed within 10 days of ownership R Must register pets within 10 days of 0 <OR> at 6 months of age if puppy/kitten residency. Feb 09 22 02;69p C��� 1� 9 p.1 shone Animal HosPbii (402) 426-3630 902 S Hwy 30 Blair, NE 68008 CITY OF BLAIR - 2021 PET LICENSE APPLICATION If you live in Blair City limits and own a dog(s) and/or cat(s), complete this Form and return with check made payable to: City of Blair • M S 1.6th St • Blair, NE 68008 You may legally own a combination of four (4) adult pets, but no more than three (3) adult dogs or three (3) adult rats per residential or dwelling unit. LICENSE RENEWALS ARE DUE; March 15, 2021 Owner Name: �, owner Address: _��~�—� V city/state/Zip: Blair, NE 68008 Phone # 44P)`Q- -714 _ -741 c LICENSE FEES: Dog or Cat: $16.00 Altered Dog or Cat: $11.00 {p Ip+T'a •$500 ***PLEASE READ CAREFULLY*** YOU ARE REQUIRED BY LAW TO LMENSE YOUR PETS. Failure to do so is a violation of City ordinances 6.103 and carries a penalty of a fine up to $150.00 per pet. PET LICENSES RENEWALS ARE DUE BY 3/1512027.. The Clty shall recognize a microchip identiflcatian number as the license number, It shalt be unlawful for any dog or cat to vrear any license or other city identification other than that issued by the City of Blair for such dog or cat. The City of Blair requires proof of rabies vaccination. Replacement Fee r g• included is a State, Fee of *1.25 being coiiecbed to fund the Nebraska Dog & Cat Operator Irtspeciion Program *PLEASE INCLUDE THE C Ty TAG NUMBER IF THIS IS A RENEWAL ** (This fee is due along with License Fee if requesting at the time of license renewal.) 1Jp Not Send Cash by Mail TOTAL ENCLOSED $ If you have questions, please contact Blair Police Department at (402) 426-4747 *+4................................................ ...+++++.+............ +++++*+++++*+�t-t-F-1.. �l .�i-...4.....+++++*..... -h++�4--F�.... NEW PETINEWRESIDENTLICENSINGREQUIREMENTS (Marrhi5lalef?edate riotappllwb,efornew,faels/newri:sia 4) AG uired Pets: New Residents to Blair. Nevis �L N Must recgster pets within 10 days or ■ rnu5t be lice 6Ed vvitYin 10 days of o�i r stVP residency. 0 <OR> at 6 months of age if puppy/Idtt�l 05/13/2022 7:12 AM FAX 4025332723 BLAIR SMALL ANIMAL 0 0001/0001 Blair Small Animal 1734 Front St 6iLd�//3/aa COY OF BLAIR - 2022 PET LICENSE APPI ICA71ON If you Ilvu In Blair CILy IirnlL: and oWn a don(,,) and/or cat(s), complete this fnrm and return with eh&k laade payable to; City of ¢lair 6 218 S 16th St * Blair, NE 68008 FAX #402-426-4195 ypp may Igyally pwn a tvnfbhtetlan of We (4) adult pots, but no MON thPn thrw (3) adult dnp9 or thrm (n) adult cats par rwidontlal or dwtlllr%g 4nl¢ LICENSE RENEWALS ARE DUE: M r h 15, 2022 t Owner -Name: �1 Owner Address: C "-1 f r l \j - r%/ ' `!z�— cit7/state/Zip: Blair, NE 68008 Phone # LICENSE FEES: Dog or Cat* $16.00 C t• 11 nn ***PLEASE REACH CAREFULLY*** YOU ARC RIEQUXRED BY LAW TO LICENSE YOUR PIET$. Fallure to do so Is 1• violation of City Ordinances d.103 and carries a pgnslly of a fine up to $150.00 per pal. PET LICENSES RENeWAI,$ ARE DuE BYALIAaM. The City shall rucoynim a microchip Identification number as the I1CenBe number. It shall BL unlawful for any doff or 4nt to wenr any litcrise or other city Identincation other than that Issued by the, City of Blair ror such dog or cut. Thin City of Blair requires proof of rables vwdnhU0r1. Altered Drag ar a . $ Replacement Fee for Lost Tag: $5,00 In hided is a StaW Fee of $1.25 being coliacW to fund the Nebraska Dog & Cat OpeneftrinspeclJ on Pltlogram PET #1 D u Cat e44dlered License Fee $ Pet Name IrthdateI Sex ` Color Breed** u�`�Replacement$ ** Declared Dangerous or Potentially dangerous Dog. ❑ Y W MICROCHIP # t q 100 d "c�_(If applicable) �-----SFI�8T+�fTAL: $ RABIES VACCINATION DATE: 1' 12 / (3 yr) i; r) City Tag # � PET #2 ❑ Qog ❑ Cat ❑ Spayed/Neutered License Fee $ Pet Name _ Birthdate Sex ** Color Breed** Replacement $ Declared Dangerous or Potentially Dangerous tog: ❑ Y ❑ N MICROCHIP # (If applicable) RABIES VACCINATION DATE: _ (S yr) PET # 3 ❑ Dog © Cat ❑ Spayed/Neutered Pet Name _ BirChdate _ Sex Color Breed** Declared Dangerous or Potentially Dangerous Dog: ❑ Y MICROCHIP # (If applicable) RABIES VACCINATION DATE: (3 yr) — SUBTOTAL: $ _ (I yr) City Tag # Ocense Fee $ Replacements $ ** ❑N SUBTOTAL: $ (1 yr) _ City Tag #* *PLEASE INCLUDE THE CITY TAG NUMBER IF THIS �$ A RENEWAL ** (This fee is due, alOng with License Fee if requesting at the time of license renewal.) Do Not Send Cash by Mail TOTAL ENCLOSF-D $ If you have cluestions, please contact Blair Policy Department at (402) 426-4747 ++++++++++++......++++++++++..+++++++++++++++.*+++++t+.4...................... NEW PET/NEW RESIDENT LICENSING REQUXREMENTS (Marsh X5/,9leFeedate not applIoNefor newpeWncwrcsidenGsJ Newiv Aea it 4md Peter: New R iidenti t4131a_IIi ■ Musk be Bwre ed within 10 Bays of ownertlip ■ Must register pcts within 10 days of ■ <OR> at 6 months of age fF puppy residency. 11301 LldiION PET 61 'E"N-- E; AP'P' CITY OF BLAIR - 0 If you live in Blair City limits and own a dog(s) and/or cat(s), complete this form and return with check made 1 City of Blair @ 218 S 16th St a Blair,, NE 68008 You may legally own a combination of four (4) adult pets,' but no,more than three,(3) adult dogs or three (3) adult cats per residential or dwelling unit. LICENSE RENEWALS ARE DUE: March 15. 2022, Owner Name. %VA' Owner Address: .-7 Z4 N. 3o' SJ-, City/State/Zip: Blair, NE 68008 Phone # 7a-ICENSE FEES.- Dog or Cat: $16.00 Altered Don or Cat: t.11,00 Replacement Fee for Lost Tag: $5.00 ***PLEASE READ CAREFULLY*** YOU ARE REQUIRED BY LAW TO LICENSE YOUR PETS, Failure to do so is a violation of City ordinances 6.103 and carries a penalty of a fine up to $150.00 per pet. PET LICENSES RENEWALS ARE DUE BY 3/15/2022. The Cltyshall recognize a microchip Identification number as the license number. It shall be unlawful for any dog or cat to wear any license or other city Identification other than that Issued by the City of Blair for such dog or cat. The City of Blair requires proof of rabies vaccination. PET ET #og J Cat . 0 Spayed/Neutered License Fee 1i- P t Name eqx4eA Birthdate Z,/*L sex 1 e- C lor Breed** M',,X. Replacement $ D clared Dangerous or Potentially Dangerous Dog: D Y *N, MICROCHIP zow % 76 56 (If applicable) SUB Y ROCHIP # 7 —Vo TOTAL:$ RIBIES VACCINATION DATE: (3 yr) (1 yr) _,C11ty Tag # 'T TT P T #2 0 Dog 0 Cat Ll Spayed/Neutered License Fee $ P Name Birthdate Sex C lor Breed" Replacement $ D clared Dangerous or Potentially Dangerous Dog: El Y EJ N CROCHIP # - (If applicable) SUBTOTAL: $ BIES VACCINATION DATE: (3 yr) - (I yr) - City Tag # PET #3 LJ Dog L3 Cat 13 Spayed/Neutered ;.License Fee $ Pet Name Birthdate Sex Color Breed" Replacement $ Declared Dang&ous or Potentially Dangerous Dog: LJ Y L3 N MICROCHIP# !' (If applicable) SUBTOTAL: $ RABIES VACCINATION DATE: -- (3 yr) _ (I yr) , - City Tag # *PLEASE INCLUDE THE CITY TAG NUMBER IF THIS IS A RENEWAL ** (This fee is due along with License Fee if requesting at the time of license renewal.) Do lVot Send Cash by Mail TOTAL ENCLOSED $ AtA If you have questions, please contact Blair Police Department at (402) 426-4747 ......................................... li.................................... NEW PET/NEW RESIDENT LICENSING REQUIREMENTS (March 151ate fee date not applIcable fbrnewpet7117ew resIdents) Newly Acquired Pets: New Residents to Blair: * Must be licensed within 10 days of ownership N Must register pets within 10 days of * <OR> at months of age if puppy/kitten residency. WILLOW PARK VETERINARY CLINIC 415 EAST ERIE ST. MISSOURI VALLEY, IA 51555 (712)642-3815 Joey & Alyssia Norton Blair, NE 68008 Page 1 / 1 Client ID: 9224 Invoice #: 171128 Date: 4/9/2021 Patient ID: 17386 Species: CANINE Weight: 70.00 pounds Patient Name: Bently Breed: MIXED Birthday: 01/20/2020 Sex: Neutered Description 4/9/2021 Wellness Exam DHLPP & Bordetella Booster HEARTWORM EXAMINATION Heartworm Negative RABIES CANINE 3 YEAR BOOSTER Bravecto 1000mg 44-88lbs Interceptor Plus 50.1-100 Blue (6) Reminder 10/09/2021 Interceptor Plus 50,1-100 Blue (6) + "9/2022 HEARTWORM EXAMINATION DHLPP & Bordetella Booster Annual Physical & Vaccinations 04/09/2024 RABIES CANINE 3 YEAR BOOSTER Staff Name Quantity Total Jack D. Gochenour, D.VM 1.00 $0.00 1.00 $36.00 1.00 $26.00 1.00 $0.00 1.00 $27.00 2.00 $115.36 T 1.34 $85.85 T Patient Subtotal: $290.21 Invoice Total: State Sales Tax Total: Balance Due: Previous Balance: Balance Due: VISA Card Number: ... XXXX6327: Less Payment: Balance Due: FINANCE CHARGE applied to all accounts unpaid after 30 days. FINANCE CHARGE is computed by a periodic rate of 1.75% per month, which is an annual percentage rate of 21.0%. MINIMUM CHARGE $2.00. $290.21 $14.09 $304.30 $304.30 $0.00 $304.30 ($304.30) ($304.30) $0.00 ® 02/07/2022 14:27 4024260101 HOLSTEIN VET CLINIC PAGE 01/01 '• I 222 PET LICENSE ' IFICATIONIAPPLICATION FOR CITY OF BL I IF YOU LIVI; IN BLAIR CITY LIMITS AND OWN A DOG(S) AND /OR CAT(S), COMPLETE THIS FORM AND RETURN WITH A CHECK PAYABLE TO: CITY OF BLAI ® 218 S. 16TH ST ® BLAIR., NE 6.9008 YOU MAY LEGALLY OWN A COM13INATION OF FOUR (4) ADULT PETS, BUT NO MORIj THAN THR'EE (3) ADULT DOGS OR THREE (3) ADULT CXrS PER RESIDENTIAL OR DWELLING UNIT. ***PLEASE READ CAREFULLY't, YQU ARE UIRED aY LAW TO LICENSE Y�fUR PETS. THE CITY OF BLAll2 REQUIRE$ PROOF CIF RABIES VACCINATION Failure to do so Is a violation 6� f City Ordinances 6J03 and carries a penalty of a fine up to $150.00 per pet, PET LICENSE RENEWALS ARE DUE BY I/15/202Z. The city shall recognize a microchip ID number as the license number. It shall be unlawful for P ydog or cat to wear any license or other city ID other than that issued by the City of Blairfor such dog or cat. VIEW PET LICENSINGust be licensed within 10 days of ownership (OR) at 6 months of age if puppy or kitten \IEW RESIDENTS TO GLAIR Must register pets within 10 days of residency Owner Name ! Robert Nownes Spouse Owner Address 245 S 23 #6 CityjState/Zip Blair, NE 68008 Phone # 402-237-4959 Pet Name; Molly W, -NSF EEES ICE Age: 14Y Sex: Spayed Female Color: Tri H>' DOB: 10.27,07 Intact Dog or Cat: $1 00 Breed: Dachshund ,. It red Microchip # ( Rabies Tag # 19438 Qog r cat: $11.0 PLEASE INCLUDE CITY AG NUMBER IF THIS IS A RENEWAL (IF AVAILABLE): # Replacement 7'eg $6.00 RABIES VACCINATIO DONE ON 08-25-21 Total $ .0 Rabies Description: ( I YEAR 3 YEAR Holstein (veterinary link Dr. Lisa Schrum DVIW : Dr. Krista Holstein DVM 718 South 161h Street Blair, NE 68008 402-426-71387 402-426-0101 Fax holsteipclinic@gmail.com PETS THgT ARE ON THE ACTIVE PQTCNTIALLY D/-�NGEROUS QR DANGER0U5 DOG LIST NEED TQ REGISTER 0/ECTLYATCITY HALL FAXED 02-07-22 BY �Tt ��:1;1.; �,:�. .,,�. ;"ii�l,i�rrk^ �.(.G�ia.tiix• ���deji�ntf,�'�I..•�}�.�!',•,,: al:`.3'd!�11i�+:.br..1i;