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DCITY OF BLAIR - 2019 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 • 218 S. 16th St. • Blair, NE 68008 3 — — 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 2019 Owner Name: hinvi Pmn U r Owner Address: A) A parka City/State/Zip: Blair, NE 68008 11qPhone # doh` = & Drivers License # or Date of Birth AVM LICENSE FEES: Dog or Cat: $16.00 Altered Dog or Cat: $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 3/15/2019. 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. inciuded is a State Fee of 51.25 being collected to tuna the NebrasKa Doa SL Cat P ET # 1 D o g 14 Cat ,'Spa ed/Neut red License Fee $ Pet N e Aye Sex Color Breed * Replacement $ �_** Decla ed Dangerous or Potentially Dangerous Dog: ❑ Y ❑ N MICROCHIP # (If applicable) SUBTOTAL: $ RABIES VACCINATION DATE: - - (3 yr) (1 yr) City Tag # �* PET #2 ❑ Dog ❑ Cat ❑ Spayed/Neutered License Fee $ Pet Name Aye 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 # PET #3 ❑ Dog ❑ Cat ❑ Spayed/Neutered License Fee $ Pet Name Aye 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.) Donation to care for animals: $1 $3 $5 $10 Other, ***SEE BACK OF FORM FOR BREED SPECIFIC LICENSE REQUIREMENTS VISA / MC # Signature Do Not Send Cash by Mail TOTAL ENCLOSED $ Expires: Security Code: If you have questions, please contact City Hall at (402) 426-4191 or by Fax: (402) 426-4195 ++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++ NEW PET/NEW RESIDENT LICENSING REQUIREMENTS(March 15late fee date not applicable fornewpets/new residents) Newly Acquired Pets: New Residents to Blair: ■ Must be licensed within 10 days of ownership ■ Must register pets within 10 days of ■ <OR> at 6 months of age if puppy/kitten residency. CITY OF BLAIR - 2019 PET LICENSE APPLICATION .r.J 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 • 218 S. 16t" St, ® Blair, NE 68008.11 ° , 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, 2019 Owner Name: Owner Address: city/state/zip: Blair, NE 68008 Phone # , Drivers License # or Date of Birth LICENSE FEES: Dog or Cat: $16.00 Altered Dog or Cat: $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 3/15/2019. 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. inciuclea is a State Fee of $]..zb Deina collectea to tuna the NebrasKa Doci & cat PET # 1 ❑ Dog L;Iz C a t Lf,,S payed/Neute ed License Fee $ L. �F Pet Name Color V'Z' 'r;'. Breed* L' Replacement $ ** Declared Dangerous or Potentially Dangerous Dog: ❑ Y ❑ N MICROCHIP # (If applicable) SUBTOTAL: $ RABIES VACCINATION DATE: (3 yr) (� yr) City Tag # PET #2 ❑ Dog ❑ Cat ❑ Spayed/Neutered Pet Name Age Sex Color Breed** Declared Dangerous or Potentially Dangerous Dog: ❑ Y MICROCHIP # (If applicable) RABIES VACCINATION DATE: (3 yr) _ M (1 yr) License Fee $ Replacement$ ** SUBTOTAL: $ City Tag # PET #3 ❑ Dog ❑ Cat ❑ Spayed/Neutered License Fee $ Pet Name Aqe 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.) Donation to care for animals: $1 $3 $5 $10 Other, ***SEE BACK OF FORM FOR BREED SPECIFIC LICENSE REQUIREMENTS VISA / MC # Signature Do Not Send Cash by Mail TOTAL ENCLOSED $ Expires Security Code: If you have questions, please contact City Hall at (402) 426-4191 or by Fax: (402) 426-4195 ++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++ NEW PET/NEW RESIDENT LICENSING REQUIREMENTS (Marchl5/ate fee date not applicable fornewpets/new residents) Newly Acquired Pets: New Residents to Blair: ■ Must be lioensed whin 10 days of ownership ■ Must register pets within 10 days of ■ <OR> at 6 months of age if puppy/kitten residency. CITY OF BLAIR - 2019 PET LICENSE VERIFICATION If you live in Blair City limits and own a dog(s) and/or cat(s), complete/verify this form and return with check made payable to: City of Blair * 218 S 16th 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 cats per residential or dwelling unit. LICENSE RENEWALS ARE DUE: March 15, 2019 LICENSE FEES: Dog or Cat: $16.00 Owner Name: William & Michele Dean Spayed/Neutered Dog or Cat: $11.00 Owner Address: 1139 Core DReplacement Fee for Lost Tag: $5.00 Corey Fee includes $1.25 for the Nebraska Dog and Cat City/State/ZIP: Blair, NE 68008--0000 Operator Inspection Program Phone #: (402) 426-5296 Drivers License #: or Date of Birth: 10/25/1965 Subtotal licensed pets from below: Replacement Tags from below: Name: Ginger DOB: Sex: Female License Fee $ Color: Fawn Breed: Chihuahua Replacement: Spayed/Neutered: True ❑Y ON Mirochip # City Tag # 200 Vaccination Date: ,0/2%2015 Duration: 3 year vaccine Vaccine Exp:_1,0/2/20'18 Total: ,u CITY OF BLAIR - 2019 PET LICENSE VERIFICATION If you live in Blair City limits and own a dog(s) and/or cat(s), complete/verify this form and return with check made payable to: City of Blair * 218 S 16th 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 cats per residential or dwelling unit. LICENSE RENEWALS ARE DUE: March 15, 2019 LICENSE FEES: Dog or Cat: $16.00 Owner Name: Steven & Janet Deemer Spayed/Neutered Dog or Cat: $11.00 Replacement Fee for Lost Tag: $5.00 Owner Address: 1403 Park St Fee includes $1.25 for the Nebraska Dog and Cat City/State/ZIP: Blair, NE 68008--0000 Operator Inspection Program Phone #: (402) 870-0363 Drivers License #:H12218832 or Date of Birth: Name: Luke Bryan Color: Black/White Spayed/Neutered: True Mirochip # Vaccination Date: 10/10/2016 Subtotal licensed pets from below: Replacement Tags from below: DOB: 2/27/2016 Sex: Male Breed: Boston Terrier Duration: 3 year vaccine Vaccine Exp: 10/10/2019 License Fee $ Replacement: ❑Y ❑N City Tag # 1814 Total: CITY OF BLAIR - 2019 PET LICENSE VERIFICATION If you live in Blair City limits and own a dog(s) and/or cat(s), complete/verify this form and return with check made payable to: City of Blair * 218 S 16th 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 cats per residential or dwelling unit. LICENSE RENEWALS ARE DUE: March 15, 2019 LICENSE FEES: Dog or Cat: $16.00 Owner Name: Steven & Janet Deemer Spayed/Neutered Dog or Cat: $11.00 Owner Address: 1403 Park St Replacement Fee for Lost Tag: $5.00 Fee includes $1.25 for the Nebraska Dog and Cat City/State/ZIP: Blair, NE 68008--0000 Operator Inspection Program Phone #: (402) 870-0363 Drivers License #: or Date of Birth: 4/22/1960 Name: Benji Color: White Spayed/Neutered: True Mirochip # Vaccination Date: 1.1/16/2017 - Subtotal licensed pets from below: Replacement Tags from below: DOB: lNot on File Sex: Male a Breed: Mix Breed Duration;�I year vaccine Vaccine Exp: 11/16/201E d License Fee $ Replacement: ❑Y ON City Tag # 2307 Total: CITY OF BLAIR - 2019 PET LICENSE VERIFICATION If you live in Blair City limits and own a dog(s) and/or cat(s), complete/verify this form and return with check made payable to: City of Blair * 218 S 16th 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 cats per residential or dwelling unit. LICENSE RENEWALS ARE DUE: March 15, 2019 LICENSE FEES: Dog or Cat: $16.00 Owner Name: Steven & Janet Deemer Spayed/Neutered Dog or Cat: $11.00 Owner Address: 1403 Park St Replacement Fee for Lost Tag: $5.00 Fee includes $1.25 for the Nebraska Dog and Cat City/State/ZIP: Blair, NE 68008--0000 Operator Inspection Program Phone #: (402) 870-0363 Drivers License #:H12218832 or Date of Birth: 4/22/1960 Name: Charlie Color: Black/White Spayed/Neutered: True Mirochip # Vaccination Date: 12/16/2015 Subtotal licensed pets from below: Replacement Tags from below: dOB Not on File Sex: Male License Fee $_ Breed: Boston Terrier Replacement: ❑Y ON City Tag # 940 Duration: 3 year vaccine Vaccine Exp: 12/161201-8 Q Total: 03/09/2019 08:59 4024260101 HOLSTEIN VET CLINIC PACE 02/03 2019 PET LICENSE VERIFICATION/APPLICA.T"ION FOR CITY OF BLAIR, IF YOU LIVE IN Bl_AIR CITY LIMITS AND OWN A DOG(S) AND /OR CAT(S), COMPLETE THIS FORM AND RETURN WITH A CHECK PAYABLE TO: CITY OF BLAIR — 218 S. 16TH ST — BLAIR, NE 68008 YOU MAY LEGALLY OWN A COMBINATION OF FOUR (4) ADULT PETS, 13UT NO MORE THAN THREE (3) ADULT DOGS OR THREE (3) ADULT CATS PER RESIDENTIAL OR DWELLING UNIT, *"PLEASE READ CAREFULLY*** YdU A,RE REQUIRED BY LAW TO LICENSE YOUF2 PETS Failure to do so is a violation of City Ordinances 6.103 and carries a penalty of a fine up to $150.00 per pet. PET LICENSE RENEWAL$ ARE DyE ay 3/15/2b19. The city shall recognize a microchip ID number as the license number. It shall he unlawful for any dog or cat to wear any license or other city ID Qther 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 5 months of age if puppy or kitten . NEW RESIDENT'S TO BLAIR Must register pets within 10 days of residency PST # j'_3 Pet 'Name: Lucy Age: BY ( sec: Spayed Female color: Red and White Breed: St. Bernard Declared Dangerous/Potentially Dangerous Dag NO YEB� Micr'�.rjochipi # 956000002893207 City Tag # /1 j ��:4101. i !�W WWip, ,nv;r.`j,.`,�ni:,lea�a��ij�•icj"!1j:vi 11�1�J1;.I{� r� . . ,4;, .Rv���1"11:1'�� ah;:, ,fi� ,.id4�, _ ^d1 i,'.L, ;!d• �'+.qil:^;rS .;�il'Ar (!� ,t, �S�S.II;S'��'�'�l'f i1,lI�II�1rTi {y.;�� Rabies Ta A 16436 {.b: •.rq i._,•: �. Lit .rl, r.�.� i.... .:u of .:.,J.l,•, :1.,1 IZIIii.:�fl�.�it � �����(�„•. lt.. .._.,.. �f ..:.^�� g Rabies Description-, 1 YEAR Holstein Veterinary Clinic Dr. Lisa Schrl.rm DVS & Dr. Krista Holstehi MM 718 South 19th Street Blair, NE 68008 102-426-7387 402-426-0101 Fax holsteindinic@gmail,com i3 LICENSE FEES Intact Dog or Cat: $16.00 C red t: $11.00 Replacement Tag $5.00 Total $ 11 r FAXED 03-09-19 8:50a BY TOTAL PAGES 03/09/2019 08:59 40242GQ101 HOLSTEIN VET CLINIC PAGE 01/03 2019 PET LICENSE VERIFICATION/APPLICATION FORCTTY OF BLAIR IF YOU LIVE 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 BLAIR — 218 S. 16TH 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 CATS PER RESIDENTIAL OR DWELLING UNIT. 'PLEASE READ CAREFULLY"* YOU ARE RE UIRED By LAW To LtCFNSE YOUR pETS. Failure to do $Q 15 a Violation of City Ordinances 6,103 and carries a penalty of a fine up to SISD.00 per pet. PET LICENSE RENEWALS ARE DUE t�Y 3 15 2Q�,g, 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_ NEWPET LICENSINQ Must be licensed within 10 days of ownership (OR) at 6 months of age if PUPPY or kitten NEW RES-1Q_E_NTS TO BLAIR Must register pets within 10 days of residency Pr'r # 113 Pet Name: Chief r Age: 3V Sex: Neutered Male color. -Srown/Wht Breed, St.Bernard Declared Dangerous/ Potentially Dangero—u—s-10--o-9--71 NO —YES Microchip Rabies Descripti6n: 1 YEAR Holstein Veterinary Clinic Dr. Li.5a Schrum DVM & Dr. Krista Holstefn DVM 718 South 19th Street Blair, NE 68008 ,02-426-7387 402-426-0101 Fax hO)5teinclinic@gmail.com City Tag # c— I i D S RabiesTag # 19125 A LICENSE FEES Intart Dog or Cat: $16.00 (AltiLo? ed ' D ()rD Cat_ o:gor cat. $11.00 Replacemant Tag $5.00 Total $ 1 FAXED, 03-09-19 8:49a BY TOTAL PAGES 03/09/2019 08:59 4024260101 HOLSTEIN VET CLINIC PAGE 03/03 2019 PET LICENSE VERIFICATION/AP PLIC,ATION FOR CITY OF BLAIR IF YOU L.IVE IN BLAIR CITY LIMITS AND OWN A DOG(S) AND /OR CAT'(S), COMPLETE THIS FORM AND RETURN WITH A CHECK PAYABLEro: CITY OF BLAIR — 21S S. 16T14 ST — GLAIR, 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. 'PLEASE READ CAREFULLY*** -YOUAMEQUIRED BYLAW TO LI+`�NSE YOUR PETS. Failure to do so is a violation of City Ordinances 6.103 and carries v penalty of a fine up to $150.00 per pet, MET —LICENSE RENEWAL5 RE DUE BY 3/15/2019. 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 11) other than that issued by the City of Blair for such dog or cat, Nt W PET LICENSING Must be licensed within 10 days of ownership (OR) at 6 months of age if puppy or kitten NEW RESIDENTS TQ BLAIR Must register pets within 10 days of residency Owner Name spouse Owner Address City/State/Zip Phone DL # or DOB PET # -31,3 Pet Name-, Sammy (Samson) Age: 22M sex. Neutered Male Breed: St Bernard Joyce Deklays 754 N 10th Ave Blair, NE 68008 630-815-1925 Color: Tri Declared Dangerous/Potentially —Dangerous Dog Microchip # 956000005077148 Rabies Description: 1 YEAR Holstein Veterinary Clinic Dr, Lisa Schrum DVM & Dr. 1fristo Holsteill DVM 718 South 19th Street Blair, NE 68008 02-426-7387 402-426-0101 Fax holsteinclinic@gmaii.com - YES City Tag # 70 Rabies Tag # 16223 3 YEAR LICENSE FEES Intact Dog or Cat: $16.00 D�g or cat: $11.00 RepWcement Too $5.00 Total $ FAXED 03-09-19 8:50a BY TOTAL PAGES I, CITY OF BLAIR - 2019 PET LICENSE ADDITIONS If you live in Blair City limits and own a dog(s) and/or cat(s), complete/verify this form and return with check made payable to: City of Blair * 218 S 16th 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 cats per residential or dwelling unit. LICENSE RENEWALS ARE DUE: March 15, 2019 Owner Name: James & Michelle Delisle Owner Address: 975 N 28th St City/State/ZIP: Blair, NE 68008 LICENSE FEES: Dog or Cat: $16.00 Spayed/Neutered Dog or Cat: $11.00 Replacement Fee for Lost Tag: $5.00 Fee includes $1.25 for the Nebraska Dog and Cat Operator Inspection Program Phone #: (402) 278-1300 Drivers License #: /A00 ° % `/ or Date of Birth: 08/28/1984 Subtotal licensed pets from below: 3 Replacement Tags from below: Total: ❑ Dog WCat V/Spayed/Neutered License Fee $ Pet Name rhC Pet DOB 7/'1 Sex Color 6()L-Jj-.- T61 Breed Oiarnea'', J 6ri he-,,l- Declared Dangerous or Potentially Dangerous Dog? ❑ YQ N Microchip # Rabies Vaccination Date 1Ile 03 yr O,l yr ❑ Dog )Cat payed/Neutered l License Fee $' Pet Name r%acl Age Sex Color C> Breed � ��a,. �. ���,�,_ 1 ,'b� Declared Dangerous or Potentially Dangerous Dog? ❑ Y N Microchip # Rabies Vaccination Date L3hltK 03 yr MI yr ❑ Dog ❑ Cat Pet Name Color ❑ Spayed/Neutered License Fee $ Pet DOB Sex Declared Dangerous or Potentially Dangerous Dog? ❑ Y ❑ N Microchip # Rabies Vaccination Date 03 yr 01 yr CITY OF BLAIR - 2019 PET LICENSE VERIFICATION If you live in Blair City limits and own a dog(s) and/or cat(s), complete/verify this form and return with check made payable to: City of Blair * 218 S 16th 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 cats per residential or dwelling unit. LICENSE RENEWALS ARE DUE: March 15, 2019 LICENSE FEES: Dog or Cat: $16.00 Owner Name: James & Michelle Delisle Spayed/Neutered Dog or Cat: $11.00 Replacement Fee for Lost Tag: $5.00 Owner Address: 976 N 28th St Fee includes $1.25 for the Nebraska Dog and Cat City/State/ZIP: Blair, NE 68008 Operator Inspection Program Phone #: (402) 278-1300 Drivers License #: 4 1170 90 or Date of Birth: 08/28/1984 Subtotal licensed pets from below: 1 Replacement Tags from below: Name: Beau DOB: 01/01/2014 Sex: Male License Fee $ Color: Brindle/White Breed: Boxer Replacement: Spayed/Neutered: True ❑Y 9N Mirochip # City Tag # 2423 Vaccination Date: Duration: 1 year vaccine Vaccine Exp: Q3/05/201-T Total; �� CITY OF BLAIR - 2019 PET LICENSE VERIFICATION If you live in Blair City limits and own a dog(s) and/or cat(s), complete/verify this form and return with check made payable to: City of Blair * 218 S 16th 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 cats per residential or dwelling unit. LICENSE RENEWALS ARE DUE: March 15, 2019 LICENSE FEES: D or Cat,: $ 00 Owner Name: John And Laurel Derry Spayed/Neutere Do or Cat: 11.00 Owner Address: 1167 Highland Dr Replacement Fee for Lost Tag: $5.00 Fee includes $1.25 for the Nebraska Dog and Cat City/State/ZIP: Blair, NE 68008-0000 Operator Inspection Program Phone #: <NO PRIMARY PHONE> Drivers License #: (� ��ri or Date of Birth: �� Subtotal licensed pets from below: Replacement Tags from below: Name: Myles Color: Tri-Color Spayed/Neutered: True Mirochip # Vaccination Date: 7/20/2016 DOB: 2/28/2005 Sex: Male Breed: Beagle Duration: 3 year vaccine Vaccine Exp: 7/20/2019 License Fee $ Replacement: ❑Y ❑N City Tag # 1965 `✓' Total: �l L� CITY OF BLAIR - 2019 PET LICENSE VERIFICATION If you live in Blair City limits and own a dog(s) and/or cat(s), complete/verify this form and return with check made payable to: City of Blair * 218 S 16th 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 cats per residential or dwelling unit. LICENSE RENEWALS ARE DUE: March 15, 2019 LICENSE FEES: Dog or Cat: $16.00 Owner Name: Sarah Detjens Spayed/Neutered Dog or Cat: $11.00 Replacement Fee for Lost Tag: $5.00 Owner Address: 2064 Lincoln St. Fee includes $1.25 for the Nebraska Dog and Cat City/State/ZIP: Blair, NE 68008 Operator Inspection Program Phone #: (402) 426-9356 Drivers License #:H12772407 or Date of Birth: 4/28/1977 Name: Faith Color: Grey Spayed/Neutered: True Mirochip # Vaccination Date: 3/16/2017 Subtotal licensed pets from below: Replacement Tags from below: DOB: 2/27/2010 Sex: Female Breed: Domestic Shorthair Duration: g year vaccine Vaccine Exp: 3/16/2019 License Fee $ Replacement: ❑Y ❑N City Tag # 552 Total: CITY OF BLAIR - 2019 PET LICENSE VERIFICATION If you live in Blair City limits and own a dog(s) and/or cat(s), complete/verify this form and return with check made payable to: City of Blair * 218 S 16th 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 cats per residential or dwelling unit. LICENSE RENEWALS ARE DUE: March 15, 2019 LICENSE FEES: Dog or Cat: $16.00 Owner Name: Sarah Detjens Spayed/Neutered Dog or Cat: $11.00 Owner Address: 2064 Lincoln St. Replacement Fee for Lost Tag: $5.00 Fee includes $1.25 for the Nebraska Dog and Cat City/State/ZIP: Blair, NE 68008 Operator Inspection Program Phone #: (402) 426-9356 Drivers License #: Name: Grace Color: Orange Spayed/Neutered: True Mirochip # Vaccination Date:_3/1612017 or Date of Birth: Subtotal licensed pets from below: Replacement Tags from below: DOB: 2/27/2010 Sex: Female Breed: Domestic Shorthair Duration year vaccine Vaccine Exp: 3/16/2019 License Fee $ Replacement: ❑Y ON City Tag # 661 Total: CITY OF BLAIR - 2019 PET LICENSE ADDITIONS w If you live in Blair City limits and own a dog(s) and/or cat(s), complete/verify this form and return with check made payable to: City of Blair * 218 S 16th 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 cats per residential or dwelling unit. LICENSE RENEWALS ARE DUE: March 15, 2019 Owner Name: Sarah Detjens Owner Address: 2064 Lincoln St. City/State/ZIP: Blair, NE 68008 Phone#: -�8 0 ,, i-,) 7Ca Drivers License #:H12772407 or Date of Birth: 4/28/1977 LICENSE FEES: Dog or Cat: $16.00 Spayed/Neutered Dog or Cat: $11.00 Replacement Fee for Lost Tag: $5.00 Fee includes $1.25 for the Nebraska Dog and Cat Operator Inspection Program Subtotal licensed pets from below: Replacement Tags from below: Total: IDog ❑ Cat payed/Neutered License Fee $ Pet Name ���� Pet DOB �(�rl%�`I Sex A Color �� a Breed `�V &(� I (a �� Declared Dangerous or Potentially Dangerous Dog? ❑ Y,N Microchip # Rabies Vaccination Date 7i yr 01 yr ■ Dog, 4 Color Declared Da NC croch-rb # N 19 M617*111114- Color _Cl) Declared Da Microch ,Spayed/Neutered C -P, '\Aae m ination Sex n Date License C) 2 V/ ❑ 1 yr ❑ 1 yr CITY OF BLAIR - 2019 PET LICENSE VERIFICATION If you live in Blair City limits and own a dog(s) and/or cat(s), complete/verify this form and return with check made payable to: City of Blair * 218 S 16th 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 cats per residential or dwelling unit. LICENSE RENEWALS ARE DUE: March 15, 2019 LICENSE FEES: Dog or Cat: $16.00 Owner Name: Shannon Devivo Spayed/Neutered Dog or Cat: $11.00 Owner Address: 736 N 13th St Replacement Fee for Lost Tag: $5.00 Fee includes $1.25 for the Nebraska Dog and Cat City/State/ZIP: Blair, NE 68008 Operator Inspection Program Phone #: (402) 677-1083 Drivers License #: H I "1 or Date of Birth: Name: Silver Color: Black Spayed/Neutered: True Mirochip # Vaccination Date: 2l 2046 Subtotal licensed pets from below: %(_19 Replacement Tags from below: DOB: 2/28/2011 Sex: Female Breed: Domestic Shorthair Duration: Ayear vaccine Vaccine Exp: 2/221201.9 License Fee $ i t , 0' Replacement: 13YON City Tag # 1629 Total:11, 0 d CITY OF BLAIR - 2019 PET LICENSE VERIFICATION If you live in Blair City limits and own a dog(s) and/or cat(s), complete/verify this form and return with check made payable to: City of Blair * 218 S 16th 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 cats per residential or dwelling unit. LICENSE RENEWALS ARE DUE: March 15, 2019 Owner Name: Sarah Detjens Owner Address: 2064 Lincoln St. City/State/ZIP: Blair, NE 68008 Phone #: (402) '�3��— �)'-7Uo Drivers License #:H12772407 or Date of Birth: 4/28/1977 Name: Hope Color: Black/White Spayed/Neutered: True Mirochip # Vaccination Date: /3116/2017 '—? � LICENSE FEES: Dog or Cat: $16.00 Spayed/Neutered Dog or Cat: $11.00 Replacement Fee for Lost Tag: $5.00 Fee includes $1.25 for the Nebraska Dog and Cat Operator Inspection Program Subtotal licensed pets from below✓ Replacement Tags from below: DOB: 3/16/2015 Sex: Male Breed: Domestic Shorthair Duration:year vaccine Vaccine Exp: 3MJW19 License Fee $_ Replacement: ❑Y 01� City Tag # 1198 �ff%% oc> Total:f�� - - CITY OF BLAIR - 2019 PET LICENSE VERIFICATION If you live in Blair City limits and own a dog(s) and/or cat(s), complete/verify this form and return with check made payable to: City of Blair * 218 S 16th 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 cats per residential or dwelling unit. LICENSE RENEWALS ARE DUE: March 15, 2019 Owner Name: DEUTSCHMAN, BENJAMIN R & ANTONIA L Owner Address: 725 N 30TH ST City/State/ZIP: BLAIR, NE, 68008--0000 Phone #: (402) 533-3402 Drivers License #:H12613513 or Date of Birth: 6/5/1983 Name: Remi Color: Yellow Spayed/Neutered: True Mirochip # Vaccination Date: 8/16/2014 "i 1,�,8 12- 0 1 LICENSE FEES: Dog or Cat: $16.00 Spayed/Neutered Dog or Cat: $11.00 Replacement Fee for Lost Tag: $5.00 Fee includes $1.25 for the Nebraska Dog and Cat Operator Inspection Program Subtotal licensed pets from below: Replacement Tags from below: DOB: Not on File Sex: Female Breed: Labrador Retriever Duratio63 ear vaccine Vaccine Exp: 8/1�2,017 License Fee $ Replacement: ❑Y ON City Tag # 27 D' C) e> Total:_ CITY OF BLAIR - 2019 PET LICENSE VERIFICATION If you live in Blair City limits and own a dog(s) and/or cat(s), complete/verify this form and return with check made payable to: City of Blair * 218 S 16th 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 cats per residential or dwelling unit. LICENSE RENEWALS ARE DUE: March 15, 2019 LICENSE FEES: Dog or Cat: $16.00 Owner Name: Shannon Devivo Spayed/Neutered Dog or Cat: $11.00 Owner Address: 736 N 13th St Replacement Fee for Lost Tag: $5.00 Fee includes $1.25 for the Nebraska Dog and Cat City/State/ZIP: Blair, NE 68008 Operator Inspection Program Phone #: (402) 677-1083 Drivers License #:H12772830 or Date of Birth: 2/22/1986 f Subtotal licensed pets from below: 11.0o Replacement Tags from below: Name: Sampson Color: White/Black Spayed/Neutered: True Mirochip # Vaccination Date 3114/2016 DOB: 2/28/2009 Sex: Male Breed: Bull Terrier Duration: year vaccine Vaccine Exp: �/14/200 --- License Fee $ [1. 00 Replacement: ❑Y1 City Tag # 1627 Total : 11- 00 CITY OF BLAIR - 2019 PET LICENSE VERIFICATION If you live in Blair City limits and own a dog(s) and/or cat(s), complete/verify this form and return with check made payable to: City of Blair * 218 S 16th 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 cats per residential or dwelling unit. LICENSE RENEWALS ARE DUE: March 15, 2019 LICENSE FEES: Dog or Cat: $16.00 Owner Name: David & Jann Dibben Spayed/Neutered Dog or Cat: $11.00 Owner Address: 1937 Soren Dr Replacement Fee for Lost Tag: $5.00 Fee includes $1.25 for the Nebraska Dog and Cat City/State/ZIP: Blair, NE 68008--0000 Operator Inspection Program Phone #: (402) 533-1173 Drivers License #:G01006588 or Date of Birth: 1/18/1962 Subtotal licensed pets from below: Replacement Tags from below: Name: Riley DOB: 11/19/2012 Sex: Female License Fee Color: Black Breed: Mix Breed Replacement: Spayed/Neutered: True ❑Y ON Mirochip # 98102006709165 City Tag # 1143 Vaccination Date: 8/20/2016 Duration: 3 year vaccine Vaccine Exp: 8/20/2019 Total: r' `` -p- q � f- w,.r t 5' CITY OF BLAIR - 2019 PET LICENSE VERIFICATION If you live in Blair City limits and own a dog(s) and/or cat(s), complete/verify this form and return with check made payable to: City of Blair * 218 S 16th 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 cats per residential or dwelling unit. LICENSE RENEWALS ARE DUE: March 15, 2019 LICENSE FEES: Dog or Cat: $1600 Owner Name: Joshua & Rhonda Ward Dick Spayed/Neutered Dog or Cat. 11..0� Replacement Fee for Lost Tag: $5.00 Owner Address: 1007 Grant St Fee includes $1.25 for the Nebraska Dog and Cat City/State/ZIP: Blair, NE 68008--0000 Operator Inspection Program Phone #: (402) 660-7250 Drivers License #:H12283929 or Date of Birth: 11/28/1976 Name: Lucy Color: Tan/Black Spayed/Neutered: True Mirochip # 495313010A Vaccination Date: 2/4/2017 Subtotal licensed pets from below: //. Of Replacement Tags from below: DOB: 7/26/2007 Sex: Female Breed: Mix Breed Duration: 3 year vaccine Vaccine Exp: 2/4/2020 License Fee $ 0. '" Replacement: ❑Y IJIN City Tag # 755 Total: �� CITY OF BLAIR - 2019 PET LICENSE VERIFICATION If you live in Blair City limits and own a dog(s) and/or cat(s), complete/verify this form and return with check made payable to: City of Blair * 218 S 16th 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 cats per residential or dwelling unit. LICENSE RENEWALS ARE DUE: March 15, 2019 LICENSE FEES: Dog or Cat: $16.00 Owner Name: Joshua & Rhonda Ward Dick Spayed/Neutered Dog or Cat: 11.0 Replacement Fee for Lost Tag: $5.00 Owner Address: 1007 Grant St Fee includes $1.25 for the Nebraska Dog and Cat City/State/ZIP: Blair, NE 68008--0000 Operator Inspection Program Phone #: (402) 660-7250 Drivers License #:H12283929 or Date of Birth: 11/28/1976 Subtotal licensed pets from below: Replacement Tags from below: Name: Nash Color: Tan Spayed/Neutered: True Mirochip # Vaccination DateU5/2812016 DOB: & .,2-- 13 Sex: Male Breed: Bulimastiff Duration: 3 year Vaccine Exp: License Fee $ P, "0 Replacement: ❑Y EIN City Tag # 1748 Total: /A ° p FRO11I : BSAC FAX 1,10. :402-533-2722 Mar% 07 2019 05:05Pri P1 CITY OF RLAIR - 2019 PET LICENSE AP'P'LICATiON 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 s 218 S.16th St, • Bialr, NE 68008 You may legally own a combination of four (4) adult pets, but no mor$ than three (3) adult dogi ur three (3) adult cats per residential or dwelling unit. LICENSE RENEWALS ARE DUE, MarCh,15, 2019- Owner Name: Owner Address., . T City/temp: Blair, NFE 680013 Phone # Drivers License # or Data Of girth LICENSE (FEES. bog or Cat: $16.00 Altered tag or Cat: $i.i,00 f L t Ta • $S Ran ***PLME READ CAREFULLY*** YOU ARE REQUIkFD BY LAW TO LICEN$fi YOUR PETS. Falidre to do so id a Violation of City ardlnanees 6,103 and carries. a penalty of a fine up to $190.00 per pet., PET LICENSES RENEWALS ARE DUE BY V-jj 2=- The City shall recognizs a microchip identincatlon number as tho licanso number. It shalle be unlawful for any dog or tat to wear any licon^or other city identifitetion other than that Issudd by the city of Bloir for such dog or cat, The city of Walr regUires proof of rables Vaccination. Replacement Fee or a4 A. ncluded is a SUW Fee of 1.2s beingcollected to fund the Nebragil Dog..Cat a afar Ins on ram PET # I. 0 �D �I Cat � Spay /Neutered License Fao � Pet Name A e m ' Sex. ** Color Breed' * Replacement�$__�..._ Declared Dangerous or P eritfall a gLL- us Dog: ©Y N MICROCHIP # 90 «1 � 1)! � G(If applicable) � SUBTOTAL, $ RABIES VACCINATION DATE: % 0� �. (3 yr) i yr) City fag PET # 2 ❑ Dog ❑ Cat --FI Spayed/Neutered License Fee $ � Pet Name„ lacement Age Sex _,.. Re ** Color Breed Declared dangerous or Potentially Dangerous Dog: ❑ Y 0 N MICROCHIP # (If applicable) SUBTOTAL: $ _ RABIES VACCINATION BATE: , _.. (3 yr) - (i yr) _ City tag PET #3 ❑ Dog Cl Cat L3 Spayed/Neutered License Fee $ Pet Name Age Sex — Re lacement $ _ Color Breed"�' Declared Dangerous or potentially Dangerous Dog: ❑ Y G N MICROCHIP # (If applicable) SUBTOTAL: $ __ RABIES VACCINATION GATE: .._.,,, (3 yr) --- (i yr) _ Clty rag #* *PLEASE INCLUDE THE CITY TAG NUMBER IF THIS TS A RENEWAL ** (This fee is due along with License Fee if requesting at the time of license renewal,) Donation to darn for animals., _ $1 $3 _ $S $10 ___ Other _ ***SEE BACK OF FARM FOR BREED SPECIFIC LICENSE REQUIREMENTS Do Not Send Cash by Mail TOTAL ENCLOSED $ VISA / MC # Expires: Security Code: Signature If you have questions, please contact City Hall at (402) 426.4191 or by Fax: (402) 428-4195 ++`I" ........ 4.4*....++++++..+++++..*................. ..... F....+.............. NEYV IPET/NEW RESIDENT LICENSING REQI)IREMENTS (M�r'h 15late fm date notappllrable %r new pets,/new n sldenN) Newly A ,glmd Pets: Now goider: ■ Must be loosed within 10 day5 e mmashlp ■ Must register pets within ].0 days of 0 <OR> at: 6 monft of Age ff hippy/kkt�en residency. CITY OF BLAIR - 2019 PET LICENSE VERIFICATION If you live in Blair City limits and own a dog(s) and/or cat(s), complete/verify this form and return with check made payable to: City of Blair * 218 S 16th 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 cats per residential or dwelling unit. LICENSE RENEWALS ARE DUE: March 15, 2019 LICENSE FEES: Dog or Cat: $16.00 Owner Name: Jackie Dodd Spayed/Neutered Dog or Cat: $11.00 1 "J'al /�, f p Replacement Fee for Lost Tag: $5.00 Owner Address: Fee includes $1.25 for the Nebraska Dog and Cat City/State/ZIP: Blair, NE 68008 Operator Inspection Program Phone #: (402) 619-1133 Drivers License #: or Date of Birth: 8/4/1978 Subtotal licensed pets from below: Replacement Tags from below: Name: Princess DOB: 3/1/2016 Sex: Female License Fee $_ Color: Grey Breed: Domestic Shorthair Replacement: Spayed/Neutered: True ❑Y ❑N Mirochip # City Tag # 1747 Vaccination Date: i 8/2016 Duration: year vaccine Vaccine Exp: 918/2 19 Total: Holstein Vet Clinic 718 South 19th Street Blair, NE 68008 402-426-7387 Printed: 03-09-19 at 10:01a CLIENT INFORMATION Name Jackie Dodd (9713) Address 792 N 10th Ave Blair, NE 68008 Phone 402 619-1133 Work:402-398-1848 PATIENT INFORMATION Name Prinny 'Species- Feline Sex Female, Spayed .Breed Dsh Birthday 01-10-15 (unknown) Age 4y (unknown) ID Rabies Color Gray&white Weight 0.00lbs Reminded (none) Codes Reminders for: Prinny Last done 09-02-20 Defensor 1 (1 Year Rabies) 09-02-17 03-08-20 Felocell4 03-09-19 Patient Chart 2019 PET LICENSE VERIFICATION/APPLICATION FOR CITY OF ECLAIR IF YOU LIVr2 IN BLAIR CITY LIMITS AND OWN A DIDG(S) ANr) /OR CAT(s), COMPLETE THIS FORM AND RETURN WITH A CHECK PAYABLE TO. OITY'OF1 BLAIR — 2iS S. 16TH ST — BLAIR, NE 68008 YOU MAY LEGALLY (AWN A COMBINATION OF FOUR (4) ADULT PETS, BUT NO MORE THAN THREE (3) ADULT DOGS OR THREE (3) ADULT CATS PER RESIDENTIAL OR DWELLING UNIT. ***PLEASE READ CAREFULLY*** Y U ARE RE UIRED BY LAW TO LICENSE YOUR PETS, Failure to do so i$ a violation of City Ordinances 6.103 and carries a pendlty of a fine up t4 $150.00 per pet. PET LICENSE RENEWALS ME DUE BY 3 15 -2019. The city shall recognize a microchip ID number as the IicenSe 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 LIC5nw Must be licensed within 10 bays of Ownership (OR) at 6 months of age if puppy or kitten NEW RESIDENTS TO BLAIR Must register pets within 10 days of residency Owner Name Spouse owner Address city/state/zip Rhone # DL # or DOB Holstein Veterinary Clink Dr. Lisa ,chrurn DVM & Dr. Krista Holstein DVM 718 South 19th Street. Blair, NE 68008 402-426-7387 402-426-01.01 Fax holsteincliniciDgmail,com T©/T© 39vd DINI-10 i3A NIOlS-IOH Pat Dougherty Marie 948 N 28th St Blair, NE 68008 402-533-238 FAXED 13Y TOTAL PAGES LICENSE FEES Intact Dag or Cat: $16.00 / Altered Dog or cat: $11. RePlacement Tag $5.00 Total $11 .00 03-05-19 9:38a TeTe93tr'0V 9b:60 6T©�71/913/60 FROM :BSAC FAX NO. :402-533-2722 Jun. 12 2019 02:44PM P1 CITY OF BLAIR - 2019 PET LICENSE APPLICATION If you live in Blair City limps and own a dog(s) and/or cat(s), complete this form and return with check made payable to: City of Blair • 218 S.-16th St. + Blair, NE 68008 You may legally own a Combination of four (4) adult pnts, but no more than three (3) adult dogs Or three (3) adult Cats per residential or dwelling unit. LICENSE RENEWALS ARE DUE: Mgrgh 15, 2019 Ownor Name; Z�u_.I f..C_.A-rti I ***PLEASE 01"CAREFULLY* %r Owner Address. ' ��, � �� . l (a, try � �f,� �t�� �� �'" YOU ARE REQUIRED 6Y LAW TO L>CENlgr,YgUR PITS. City/State/Zip: Blair, NE 68008 rallureto do so is a vloladon of City ordinariam 6.103 and carries ( o penalty of a fine up to $150.00 per pet. #hone # �" / %'`� PKT LXCENSES RENEWALS ARE DUE BY 441W2M. '17t,a city rhall Drivers License # or Data of Birth recoonixo ei mlcrochip Identificatlan number as t1io lice ra number, It shall be unlawful for any dog or cat tv wear any iiconsa or other city LICENSE FEE$q Dog or Cat; $16.00 idahkifitition other than that Issued by the (Jky of fllair for such dog or cat. The City of Blair requires proof of rabies vaccination. Altered Dog or Cat: $11.00 Replacement Fete for Lost Tag; $5.00 PET #1 vd-Dog Lj Cat ❑ Spayed4'Neutered � License Fee $___i" Pet Name L_r t_\ Acie _.__..:�... sex _ Color -• Breed, L m-t4- - Roplacement $_ Declared Dangero $ or potentially dangerous Dog: ❑ Y t0'N MICROCHIP # (If applicable) SUBTOTAL: $ RABIES VACCINATION DATE: �• 1,p, (3 yr) (I yr) City Tag # PET #2 ❑Leg Ll Cat ❑ Spayed/Neutered License Flee $� Pet Name An sex Color Breed * Replacement ** Declared Dangerous or Potentially Dangerous Dog: © Y ❑ N MICROCHIP # (If applicable) SUBTOTAL: $ —R-� RABIES VACCINATION DATE, (3 yr) — (1 yr) City Tang # PIET #3 ❑ Udrg U Cat © Spayed/Neutered License Fee $� Pet Name W W Age Sex Color �--_-.... reed* Declared Dangerous or Potentially Dangemus deg: ❑ Y ❑ N MICROCHIP # (If applicable) SUBTOTAL: $ RABIES VACCINATION MATE: (3 yr) (1 yr) _ City Tag # _ *PLEASE INCLUDE THE CITYTAQ NUMBER IF THIS IS A RENEWAL ** (This fee Is due along with License Fee If requesting at the time of license renewal.) Donation to rate for Enimaks: _ $1 $ $5 $10 � Other ***SRE BACK OF FORM FOR BREED SP CIFIC LICENSE REQUIREMENT'S Poftt$endCas�hbyMarr TOTAL ENCLOSED $ VISA / MC # Expires: Security Code: Signature _•_,• •• If you have questions, please contact City Wahl at (402) 426.4191 or by Fox. (402) 426-4195 ++++++++t++t+++++++4++++++t++++t+++.++++++++++++++h+++.+t+t+++Md4++++++t+....+ NEW Prr/NEW RESIDENT LICENSING REQUIREMENTS (Mara'.l5lat&Medate not applicable &nawpeWhewreslderus) �l4AMIV. Arltlulred ": Now ResidenttC to Blair: ■ Must be MNted within t0 dxysclf ow—m—s' ip i MUSE register pets within 10 days of ■ <QRa, at 6 maittts of ace if puppy/kim r 4dency. CITY OF BLAIR - 2019 PET LICENSE VERIFICATION If you live in Blair City limits and own a dog(s) and/or cat(s), complete/verify this form and return with check made payable to: City of Blair * 218 S 16th 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 cats per residential or dwelling unit. LICENSE RENEWALS ARE DUE: March 16, 2019 Owner Name: Susan & Michael Dreher Owner Address: 747 N 11th St City/State/ZIP: Blair, NE 68008--0000 Phone #: (402) 426-0107 LICENSE FEES: Dog or Cat: $16.00 Spayed/Neutered Dog or Cat: $11.00 Replacement Fee for Lost Tag: $5.00 Fee includes $1.25 for the Nebraska Dog and Cat Operator Inspection Program Drivers License #: or Date of Birth: 8/9/1969 Subtotal licensed pets from below: Name: Buddy Color: Yellow Spayed/Neutered: True Mirochip # Vaccination Date: 3/9/2017 Replacement Tags from below: DOB: 3/1/2012 Sex: Male Breed: Labrador Retriever Duration: 3 year vaccine Vaccine Exp: 3/9/2020 License Fee $ Replacement: ❑Y N City Tag # 1069 Total: 2019 PET LICENSE VERIFICATION/AP'P'LICATION FOR CITY OF'-BLAIR IF YOU LIVE 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 BLAIR — 218 S. I6TH 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 CATS PER RESIDENTIAL OR [DWELLING UNIT. ***PLEASE READ CAREFULLY*** YDU ARE REQUIRED BY I,AW 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 LICENSE RENEWALS ARE bllE gY 3/15/2019r 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 kittenNEW RESIDENTS TO BLAIR Must register pets within 10 days of residency owner Name Nancy Dudley $pause Gerald Owner Address 1451 Jackson St city/statelzip Blair, NE 68008 Phone # 402-669-7498 DL # or DOB PE'T # Pet Name: SiSSy Age: 6Y ayed Fernale Color: White Breed: BichDO X Declared Donger�us/Potentially Dangerous Dog NO 'yiE� Microchip # City Tag # q i m ��� ' �yi N°�+{�i� r� j'�'I•#`'� opf q� 'e`.aol,�; Rabies Tag#197 000 wnMYi ;ti Rabies Description," I YEAR YEAR Holstein Veterinary Clinic Dr. Lisa Schrum DVM & Dr: k ista Holstein DVAII 718 South 19th Street Blair, NE 68008 402-426-7387 402-426-0101 Fax holsteindinic@gmail.com 30/30 39vd DINI-10 13A NIELLS-101-1 LICENSE FEES Intact Drag or Cat: $16.00 e o or cat: $11. Rep #cement Tag $5.00 Total FAXED 01-24-19 12:12p BY TOTAL PAGES TOT09Zb60b b6:7,T 6T0Z/bZ/T0 2019 PET LICENSE VERIFICATION/APPLICATION FOR CITY OF BLAIR W YOU LIVE IN BLAIR CITY LIMITS IAND OWN A DOG(S) AND /OR CAT(S), OOMPLC-TE THIS FORM AND RETURN WITH A CHECK PAYABLE TO: CXTY OF BLAIR — 218 B. 16TH BT — BLAIR, NE 68008 YOU MAY LEGALLY OWN A COMBINATYON OF FOUR (4) ADULT PETS, BUT NO MORE THAN THREE (3) ADULT DOGS OR THREE (3) ADULT CATS PER RESIDENTIAL OR DWELLING UNIT. ***PLEASE READ CAREFULLY*** YOU ARE REQUIRED BY LAW TO LICENSE YOUR PETS. Fallure 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 LICENSE RENEWALS ARE DUE BY 3/15/2019. 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 ref Blair for such dog or cat. NEW PET LICENSING Must be licensed within 10 days of ownership (OR) at 6 months of ago if puppy Or kitten NEW RESIDENTS TO BLAIR Must register pets Within 10 days of residency Owner Name Nancy Pudley Spouse Gerald Owner Address 1451 Jackson St City/Mate/Zlp Blair, NE 68008 Phone # 402-669-7498 DL # or ROB PET # Pet Name: Buddy/,:"r t�r. Age: 9Y sex: Neutered Male Color. Brrown/Wht Breed: BOstOn Declared Dangerous/Potentially Dangerous Dog NO YEs Microchip # City Tag # ry ,•�I..;?,: T¢¢71ar, Y ';� ��,.n�ir+;1i1.5F '"iliiY° I'I'•:.1'HSS B1.1 J" 'e. i Mil°�i�!j ��� .t"c ;°og.,�e %'�r �• �II (;r�.;. ,.I.�; i -IyFh t:•.I�nI��.n_rd'r-•'. y� w� IIt31: if. r p hl s: .! � �i�i r I r••I, d"Ri) Vdl I Ilf I '0 :,in I�F1�� x I ,ii4rh1`%°u,l 91�1y1.,-�l�il� f� I n a _t�..._4 ,I;}!!�:!ika,i ':V .f.l. b' le1 lV. (J'..!C. ... It �J(NVfe N Y"II•. A:VI'P}l'I I11� - Vi •.. �I� < ,�.klr �i nun � Qi��i� �.yll��il Rabies Description: 1 YEAR %Za171esTad 1�i�?99 EAR Holstein Veterinary Clinic Dr, Lisa Schrum DVM & Dr. Krfsta Holstein DVM 718 South 101h Street Blair, NE 68008 402-426-7387 402-426-0101 Eax holsteinclinic@gmail.com LICENSE FEES Intact Dag or Cat: $16.00 DQ Q!rc at: $!�10) Replacement Tag $5,00 . Total FAXED 01-24-19 12:11p BY TOTAL PAGES I Z©/T8 39Vd DIFII-10 13A NI3I5_I0H T0T09ZPZ0h bE:ZT 6T©Z/bZ/T0 CITY OF BLAIR - 2019 PET LICENSE VERIFICATION If you live in Blair City limits and own a dog(s) and/or cat(s), complete/verify this form and return with check made payable to: City of Blair * 218 S 16th 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 cats per residential or dwelling unit. LICENSE RENEWALS ARE DUE: March 15, 2019 LICENSE FEES: Dog or Cat: $16.00 Owner Name: Patrick L And Karen K Dunham Spayed/Neutered Dog or Cat: $11.00 Replacement Fee for Lost Tag: $5.00 Owner Address: 454 N 15th St Fee includes $1.25 for the Nebraska Dog and Cat City/State/ZIP: BLAIR, NE 68008-0000 Operator Inspection Program Phone #: <NO PRIMARY PHONE> Drivers License #:G29006885 or Date of Birth: 7/1/1955 Name: Dakota Color: Tri-Color Spayed/Neutered: True Mirochip # 054-300-527 Vaccination Date: 2/6/2016 Subtotal licensed pets from below: ` ttt Replacement Tags from below: E e;16 DOB: 11/1/2010 Sex: Male Breed: Shetland Sheepdog Duration: 3 year vaccine Vaccine Exp: 2/6/2019 License Fee $ Replacement: ❑Y ON City Tag # eX Total L v - ej �M�dAm*m�,Jl VCA 80 Dodge Animal Hospital 8022 West Dodge Road Omaha, NE 68114 (402) 399 - 8100 RABIES VACCINATION CERTIFICATE (REPRINT) Pet's Name: Dakota Species: Canine Breed: Sheepdog, Shetland Sex: Male (Neutered) B i rt h d ate : 11/01/2010 Color: Tri Weight: 32 lb Date of Vaccination: 2/2/2019 Date Due: 2/2/2022 Microchip: 054*300*527 Duration: Owner: Karen Dunham 454 North 15th Street Blair, NE 68008 (402) 278 - 0608 Vaccination information Verified at VCA 80 Dodge Animal Hospital Manufacturer: Pfizer/Zoetis Defensor 3 Lot/Serial Number: 288180 Lot Expiration: 9/24/2019 Tag Number: 19-3656 By: Batenhorst DVM, Lynn License Number: CITY OF BLAIR - 2019 PET LICENSE VERIFICATION If you live in Blair City limits and own a dog(s) and/or cat(s), complete/verify this form and return with check made payable to: City of Blair * 218 S 16th 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 cats per residential or dwelling unit. LICENSE RENEWALS ARE DUE: March 15, 2019 LICENSE FEES: Dog or Cat: $16.00 Owner Name: Patrick L And Karen K Dunham Spayed/Neutered Dog or Cat: $11.00 Owner Address: 454 N 15th St Replacement Fee for Lost Tag: $5.00 Fee includes $1.25 for the Nebraska Dog and Cat City/State/ZIP: BLAIR, NE 68008-0000 operator Inspection Program Phone #: <NO PRIMARY PHONE> Drivers License #:G29006885 or Date of Birth: 7/1/1955 Subtotal licensed pets from below: Replacement Tags from below: O Name: Sassy DOB: 3/29/2004 Sex: Female License Fee $ Color: Brown Breed: Shetland Sheepdog Replacement: Spayed/Neutered: True ❑Y [IN Mirochip # 087884295 City Tag # 5 Vaccination Date: 6/20/2017 Duration: 3 year vaccine Vaccine Exp: 5/20/2020 tT") S Total: VCA 80 Dodge Animal Hospital 8022 West Dodge Road Omaha, NE 68114 (402) 399 - 8100 RABIES VACCINATION CERTIFICATE (REPRINT) Pet's Name: Sassy Species: Canine Breed: Sheepdog, Shetland Sex: Female (Spayed) Bi rthdate: 03/29/2004 Color: Brown Weight: 19.9 lb Date of Vaccination: 5/20/2017 Date Due: 5/20/2020 Microchip: 087*884*295 Duration: Owner: Karen Dunham 454 North 15th Street Blair, NE 68008 (402) 278 - 0608 Vaccination information Verified at VCA 80 Dodge Animal Hospital Manufacturer: Pfizer/Zoetis Defensor 3 Lot/Serial Number: 170031C Lot Expiration: 1/9/2018 Tag Number: 17-0843 By: Batenhorst DVM, Lynn License Number: