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E"''- -0 V% 6 �� 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: Chris or Becky Eastman Spayed/Neutered Dog or Cat: $11.00 Replacement Fee for Lost Tag: $5.00 Owner Address: 243 S 25th St Fee includes $1.25 for the Nebraska Dog and Cat City/State/ZIP: Blair, NE 68008 Operator Inspection Program Phone #: (402) 237-0093 Drivers License #:H13519975 or Date of Birth: 7/3/1980 I ( a Subtotal licensed pets from below: Replacement Tags from below: �- Name: Charlie DOB: 6/3/2010 Sex: Male License Fee $ Color: White/Brown Breed: Mix Breed Replacement: Spayed/Neutered: True ❑Y ON Mirochip # 4C263BOF2D City Tag # 1699 Vaccination Date: 3/17/2017 Duration: 3 year vaccine Vaccine Exp: 3/17/2020 01 Total:= 02/25/2019 17:31 4024260101 HOLSTEIN! VET CLINIC PAGE 01/01 2019 PET LICENSE VERIFICATION/APPLICATION FOR CITY OF GLAIR 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 GLAIR -T 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 DUGS OR THREE (3) ADULT CATS PER RESIDENTIAL OR DWELLING UNIT. ***PLEASE READ CAREFULLY*** YOU ARE RtQUIRED BY LAW TO LICENSE YgUR PETS Failure to d4 so is a violation of City Ordinances 6.103 arid carries a penalty of a fine up to $150.00 per pat. PET LICENSE RENEWALS ARE DUE BY 3/� 5/2019. The city shall recognize a microchip ID number as the license number. It shall be unlawful for any dog or eat 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 Must register pets within 10 days of residency Holstein Veterinary Clinic Dr. ,Lisa Schrum DVM & Dr. Krista .flolsteirj ,0Vi�I 718 South 19th Street Blair, NE 68008 402-426-7387 402-426-0101 Fax holsteinclinic@gmaiI.com LICENSE FEES og or fat: $16. 0 Altered Dog or cat: $11.00 Replacement Tog $5.00 Total S 4 DO FAXED 02-25-19 5:16p BY TOTAL PAGES , D� FROM : BSAC FAX NO. : 402-533-2722 Mar. OB 2019 06: 06PI°i P3 CITY OF BLAIR - 2019 PET LICENSE VERIFICATION If you live in Blair City limps find own a dog(s) And/or cat(a), 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: Carroll & Ginger Edgell Spayed/Neutered Deg or Clit: , Replacement Fee for Lost Tag:: $5.00 Owner Address; 111 Fairview DrReplacement includes $1.25 for the Nebraska Dog and Gat Uly/State/ZIP: Blair, NE 68008--0000 Operator Inspection program Phone #: (402) 426-4476 Drivers License #:029007238 or Gate of girth: 7/13/1939 _ - Subtotal licensed 'pets fro,im, below: Replacement Tags from below: Name,.�,�ger ) Color: Grey Spayed/Neutered: True Mirochip # 985112006030760 Vaccination Date: 2/2612017 DOB: 4/17/2016 Sex: Male Breed: Domestic Longhair Duration:year vaccine Vaccine Exp: 2/26/2019 License Fee $4 Replacement: ❑YAWN City Tag # 1718 Total: FROM :BSAC FAX N0. :402-533-2722 Mar. 00 2019 06:06PIhI P2 CITY OF BLAIR - 2019 PEA' LICENSE VERIFICATION If you live in Blair City limits and own a dog(s) and/or cat(B), completelverify this form and return with check made payable to: City of Blair* 218 S I Gth St. * Blair, NE 68008 You may legally own a combination of four (A) adult pets, but no more than three (3) adult dogs or throo (3) adult cats per residential or dwelling unit. LICENSE RENEWALS ARIw DUE: March 157 2019 LICENSE FEES: Dog or Cat: $16.00 Owner Name: Carroll & Ginger Bdgell Spayed/Neutered Dog or Gat e n Ad ) iieplacement Fee for host Tag;.00 Owner Address: 111 Fairview Dr Fee Includes $? 25 for the Nebraska Dog and Cat City/State/ZIP: Blair, NE 68008--0000 bperatar Inspection program Phone #: (402) 426-4475 Drivers License #:C29007238 or ?ate of Birth: 7/13/1939 Subtotai' IYcsnsetf p"ts fro'm 'beloW:_ Replacement Tags from below: Na ti Lucky Color: Calico Spayed/Neutered: True Mirochip # 986111000168788 Vaccination Date: 2/26/2017 DOB: 9/11/2013 Sex: female Breed: Domestic Shorthair Duration 4 year vaccine Vaccine Exp: 2/26/2019 License Fee $ j Replacement: ICY J#N City Tag # 1407 Total: FROM :BSAC FAX NO. :402-533-2722 Mar. 00 2019 06:06PM P1 CITY OF BLAIR - 2019 PET LICENSE VERIFICATION If you live In Blair City limits and own a dog(s) and/or cat(s), completelverify this form and return with check made payable to; City of Blair * 218 8 16th St. * Blair, NE 68008 You may legally own a combination of four (4) adult pots, but no more than three (3) adult dogs or three (3) adult cats per residential of dwelling unit. LICENSE RENEWALS ARE DUE: March 15, 2019 LICENSE FEES: Dog or Cat: $16.00 Owner Name: Carroll & Ginger Edgell Spayed/Neutered Clog or Replacement Fee for Lost Tag: $5.00 Owner Address; 1118 Fairview pr Fee includes $1.25 for the Nebraska 1104 and tat City/State/ZIP: Blair, NB 68008--0000 Operator Inspection Program Phone #: (402) 426-4476 Drivers License M029007238 or Date of Birth: 7/13/1939 - - Subtotal licensed pets from below; Replacement Tags from below. Color; Orange Spayed/Neutered: True Mirochip # 985112001333764 Vaccination Date: 2/26/2017 DOB: 7/2/2013 Sex: Male Breed: Domestic Shorthair Duratlor q year vaccine Vaccine Exp: 2/26/2019 License Fee Replacement; DY #N City Tag # 2000 Total: FROM: BGAC FAX HO. : 4©2-533-2722 I°tar. 08 2019 06: 14PI°i P1 CITY OF BLAIR - 2019 PET LICENSE ADDITIONS If you live in Blair City limits and own a dog(s) andlor oat(s), complete/verify this fonn 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 DUP.- March 16, 2019 Owner Name: Carroll & Ginger Bdgell Owner Address: 1119 Fairview Dr City/State/ZIP: BI01r, NE 68008--0000 Phone #: (402) 426-4475 Drivers License #:G29007238 or Date of Birth: 7/13/1939 VICPNSP FEES: Dag or Cat: $16.00 Spayed/Wutered Dog of Cot; $11,00 Replacement Pee for Lost Tag: $5.00 Fee includes $1.25 for the Nebraska Dog And Cat Operator Inspection Program Subtotal licensed pets from' 66low: Replacement Tags from below: Total: ------,.,..,, a .. ......... -- ...... El Dog Spayed -.... Dog p y Neutered License Fee $ -,�— Pet Name ��1 (' Pet DOB 1 Sex yl Color L>��_ Breed Declared Dangerous or Potentially Dangerous Dag? ❑ Yi N Microchip # Rabies Vaccination Date yr El Dog []Cat 0 Spayed/Neutered Pet Name Age Sex CoI4r... Breed Declared Dangerous or Potentially Dangerous Dog? ❑ Y ❑ N Microchip # Rabies Vaccination Date Q Dog © Cat ❑ Spayed/Neutered Pet Name Pet DOB --- -- Sex Color Breed Declared Dangerous or Potentially Dangerous Dog'? ❑ Y ❑ N Microchip Rabies Vaccination bate License Fee $ 17113 yr 01 yr License Fee $ 03 yr Li yr iL&4 4F V tCCIL �7- 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: Conn4sM iscri Spayed/Neutered Dog or Cat: $11.00 Replacement Fee for Lost Tag: $5.00 Owner Address: 1362 Colfax St Fee includes $1.25 for the Nebraska Dog and Cat City/State/ZIP: Blair, NE 68008--0000 Operator Inspection Program Phone #: (402) 426-9007 Drivers License #. (o )j or Date of Birth: Subtotal licensed pets from below: — Replacement Tags from below: Name: Zoiee DOB: 10/01/2015 Sex: Female License Fee $ Color: Brown/Tan Breed: Chihuahua Replacement: Spayed/Neutered: False ❑Y N Mirochip # City Tag # 2458 Vaccination Date: 10/13/2017 Duration: 3 year vaccine Vaccine Exp: 10/13/2020 Total: /4"' 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. -Connie -Wilson Spayed/Neutered Dog or Cat: $11.00 Replacement Fee for Lost Tag: $5.00 Owner Address: 1362 Colfax St Fee includes $1.25 for the Nebraska Dog and Cat City/State/ZIP: Blair, NE 68008--0000 Operator Inspection Program Phone #: (402) 426-9007 #" d>1 Ld or Date of Birth: Drivers License Subtotal licensed pets from below: Name: Rita Color: Brown/Tan Spayed/Neutered: False Mirochip # Vaccination Date: 09/24/2018 Replacement Tags from below: DOB: 09/01/2013 Sex: Female Breed: Chihuahua Duration: 1 year vaccine Vaccine Exp: 09/24/2019 License Fee $ ' • bj Replacement: ❑Y City Tag # 2459 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: EDWARDS, RICHARD L & KATHLEEN L Spayed/Neutered Dog or Cat: $11.00 Replacement Fee for Lost Tag: $5.00 Owner Address: 1117 N 20TH AVE CIR Fee includes $1.25 for the Nebraska Dog and Cat City/State/ZIP: BLAIR, NE, 68008--0000 Operator Inspection Program Phone #: (402) 533-1050 Drivers License #: or Date of Birth: 8/11/1944 Name: Star Color: Sable Spayed/Neutered: True Mirochip # 981020005709734 Vaccination Date:M7-12312015 Subtotal licensed pets from below: Replacement Tags from below: DOB: 1/11/2014 Sex: Female Breed: Shetland Sheepdog Duration: 3 year vaccine Vaccine Exp: /23/2018 License Fee $ Replacement: ❑Y ON City Tag # 1536 Total: k,c,4 11 q 9)3 y 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: John & Paula Ellis Owner Address: 683 Hillcrest Dr City/State/ZIP: Blair, NE 68008--0000 Phone #: (402) 699-6157 Drivers License Name: Reggie Color: Golden Spayed/Neutered: True Mirochip # Vaccination Date: 4/15/2017 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 or Date of Birth: 9/22/1964 ��� ' `v Subtotal licensed pets from below: Replacement Tags from below: DOB: 12/1/2015 Sex: Male Breed: Mix Breed Duration: 3 year vaccine; Vaccine Exp: 4/16/2020 License Fee $ Replacement: ❑Y ON City Tag # 2087 Total: �y CITY OF FLAIR - 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: John & Paula Ellis Spayed/Neutered Dog or Cat: $11.00 Replacement Fee for Lost Tag: $5.00 Owner Address: 683 Hillcrest Dr Fee includes $1.25 for the Nebraska Dog and Cat City/State/ZIP: Blair, NE 68008--0000 Operator Inspection Program Phone #: (402) 699-6157 Drivers License #: Name: Lilly Color: Black/Brown/Grey Spayed/Neutered: True Mirochip # Vaccination Date: 10/19/2016 ' or Date of Birth: 9/22/1964 Subtotal licensed pets from below: Replacement Tags from below: DOB: 3/15/2007 Sex: Female Breed: Domestic Shorthair Duration: 3 year vaccine License Fee $ Replacement: ❑Y ❑N City Tag # 690 psi Total: I I CITY OF GLAIR - 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: John & Paula Ellis Spayed/Neutered Dog or Cat: $11.00 Owner Address: 683 Hillcrest 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) 699-6157 Drivers License #: or Date of Birth: 9/22/1964 Name: Timmy Color: Black/Brown/Grey Spayed/Neutered: True Mirochip # Vaccination Date: 913/2016 Subtotal licensed pets from below: Replacement Tags from below: DOB: 3/15/2007 Sex: Male Breed: Domestic Shorthair Duration: 3 year vaccine License Fee $ Replacement: ❑Y ON City Tag # 686 A �v Total: 11, " 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: John & Paula Ellis Spayed/Neutered Dog or Cat: $11.00 Owner Address: 683 Hillcrest 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) 699-6157 Drivers License #: or Date of Birth: Subtotal licensed pets from below: Replacement Tags from below: Name: Cocoa DOB: 3/26/2010 Sex: Male License Fee $ Color: Black/Grey Breed: Mix Breed Replacement: Spayed/Neutered: True ❑Y ON Mirochip # City Tag # 687 Vaccination Date 2 A" #4 Duration: 3 year vaccine 3/lo/)g Vaccine Exp: "'zrr-"42el$ r'An! C-e d'1(; c r��( [n c 1 Uscd Total: CERTIFICATE OF VACCINATION Date of Rabies Vaccination: 03-10-18 Certificate No: 0 Next Rabies Vaccination On: 03-09-21 Previous Rabies Vaccination: 001804 VETERINARY CLINIC OWNER OF ANIMAL Thone Animal Care of Blair John Ellis 902 S Hwy 30 683 Hillcrest Dr Blair, NE 68008 Blair, NE 68008 402-426-3630 County: This is to certify... THAT I HAVE VACCINATED AGAINST RABIES THE ANIMAL DESCRIBED BELOW. Patient information... PATIENT: Cocoa TAG NO: 003950 SPECIES: Canine WEIGHT: 41.00 SEX: N AGE: 10 years Color and markings... Black and Tan Signed Dr. Leon Leishman Vaccinations done... License: 1971 03-10-18 LL Rabies Vaccination (3 Year), #003950 03-09-21 03-10-18 LL Bordetella, PI3 (Intra-trac 3) 03-10-19 03-10-18 LL Check up, DA2PPV 03-10-19 02-09-13 LL DA2PPV 03-10-19 01-31-09 LL Rabies Vaccination (3 Year), #11074 03-09-21 02-09-08 KH Rabies Vaccination (1 Year), #9704 Rabies Vaccine Information... 03/09/2019 12:26 4024260101 HOLSTEIN VET CLINIC PAGE 01/01 2019 PET LICENSE VERIFICATION/AP'PLICATION POR CITY OF 13LAIR 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, 18Y" 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 P0, RESIpBNTIAL OP DWELLING UNIT. ***PLEASIE READ CAREFULLY"* YOU ARE RES. Failure to do so is a violation of City Ordinances GAD3 and carries a penalty of a fine up to $150.00 per pet. PET LICENSE RENEWALS ARE DUE BY 3 15 2b19- The city shill 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 LICENSIN(a Must be licensed within 10 days of ownership (OR) at 6 months of age If puppy or kitten NEW RESIDENTS, TO BLAIR Must register pets within Zia days Of residency Owner Name Spouse Owner Address City/State/Zip Phone # DL # or DOB 3,028 Park Street Blair, NE 68008 402-426-0285 Pet Name: Tiger Age; Sy sex; Neutered Male [�Co�lorr::::G:ray tabby Breed, Domestic 8horthair Declared Dangerous/potentially Dangerous peg NO YES Microchip # Rabies Description: 1. YEAR Holstein Veterinary Clinic Dr. Lisa Schrum D•VN & Dl-. Krxtista Holstein DVM '18 South 191h Street Blair, NE 68008 402-426-7687 402-426-0101 Fax holsteinclinic@gmail.com city -rag # ( \, fables 'Tag # LICENSE FEES Intact Clog or cats $16.00 9t, L$II-100 Qa Replacement 7°ag $5.00 Total 1 �'00 �P Mar 12 19 07,13a Thone Animal Care 4024265808 p,1 CITY OF FLAIR - 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 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: J3'!S�I 0� S•T city/state/zip: Blair, NE 68008 Phone#k —I�)a- �) t% ,- ,-)'�99 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 Included isa State fee of $1.25 being collected to fund the ***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 /15/2018, The City shall recognize a microchip identification number as the license number, It shall he Lin awful 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 # 1 91 Dog ❑ Cat i F Spayed/Neutered License Fee $ 6.00 Pet Name Aye �-1 Sex i' r Colo1.,k1 J1 Breed*—���,+rt�f i� _Replaacement$ ** Declared Dangerous or Potentially Dangerous Dog: ❑ Y,t] N MICROCHIP # (If applicable) SUBTOTAL: $ �U RABIES VACCINATION DATE: _ . } ! - I°1 (3 yr) (1 yr) City Tag # PET #2 El Dog ❑Cat ❑Spayed/Neutered License Fee $ Pet Name Age Sex Color Breed** Replacement $ ** I Declared Dangerous or Potentially Dangerous Dog: ❑ Y © N MICROCHIP #_ (If applicable) SUBTOTAL: $ RABIES VACCINATION DATE: (3 yr) (1 yr) City Tag # PET #3 ❑ Dog q Cat ❑ Spayed/Neutered License Fee $ Pet Name Ave 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 ** (Thls fee is due along with License Fee if requesting at the time of license renewal.) Donation to care for animals: ***SEE BACK OF FORM FOR BREED SPECIFICS XCENSE REQUIREMENTS Other VISA / MC # Signature Do Not Send Cash by Mall TOTAL ENCLOSED $ Expires: Security Code: If you' have questions, please contact City Hall at (402) 426-4191 or by Fax: (402) 426-41.95 +++++++++++++++++++.f+++++++++++++++++++++++++++++++++++++++i-+++•h++++++++++++++ NEW PET/NEW RESIDENT LICENSING REQUIREMENTS (Alarch iSlate fee date not applicable for newpehs/newresidentsj Ne l y AcclulLed Pets: New Residents to Blair, ■ Must be ficensed Mthh 10 days cfovvnel4tione Animal! Care Of K Mesid register gi ter pets within 10 days of u <OR> at 6 mongis of age if puppy/kitten (402) 426-3630 902 S. Hwy 30 Blair, NE 68008 FROM :BSAC FAX NO. :402-533-2722 Sep. 03 2019 02:33PM P1 CITY 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; CRY of 01air • 218 S.16th St, 0 Blair, NE 68008 You may legally own a combination of four (4) adult pets, but no more than three (3) adult days or three (3) adult cats per residential or dwelling unit. LICENSE RENEWALS ARE DUE, 4T�)o 4Wner Name- r Owner Address; A • ,{r -� city/state/zip: Blair, WE 68008 Phone ,� �? Drivers License # or Data, of girth LICENSE FLESM Dag or Cat: stfi.00 Altvred Vogl or Cat: $11.00 ItePlacament Fee for Lost Tag: $%()o Xitduded is a State Fee041..25 being +collected to fund the ***PLOW READ CAR1 lGR, LLY*** YOU Ak9 hrQUIRkD By 1,AW TO LICENSE YOUR MS. Failure to do !9P In a violRdon of City Ordinances $.109 anti c4lrriop a penalty or a fine up to $160.00 per pet. PET LICENSE$ KN WA0 ARE OUR BY 3i1S121118 Thn Clly shall raengnl- a ntirroMp Iddntificatlon number as the Ilcensa number. It shall be unlawful for any dog or cat to Wear any license Qr 01w City Identifithilon other than that Issued by tho City of Blair for Mich tlog or cat. The City of Ulnir requires proof of cables vaeelgPt(gn, T #1 ❑ Cat ❑ Spaye Neutered ItIr 1L►I . License Fee ao Pet Name �0 __ I AColor -�kate Sex Declared dangerous or g Broad * Replacement $ Potentially Dangerous pry: �I Y �I N b` I MICROCHIP # (If applicable) SUBTOTAL,- $ � RABIES VACCINATION DATE., (3 yr) (1 yr) - City Tag # PET # 2 Dag I' Cat ®spayed/Neutered � �-- License Fee �� 70 Pet Name Awge Sex Color wed * Replacement Declared Dangerous or Potentlall Dan Brous Dog: t Y N MICROCHIP #q 5W 06Q 7 3Npt-( (Tf applicable SUBTOTAL,: $ RABIES VACCINATION MATE: q / o�,��" /� (3 yr) , (� yr) City T;19 # � PET #3 U Dog ❑ Cat ❑ Spayed/Neutered License Fee Pet NameColor AveA* Sex , ,.� need Replacoln nt$ ** Declared Dangerous or Potent-1-ally Dangerous Dog. ❑ Y ❑ N MICROCHIP # (If applicable) SUBTOTAL,: $ RABIES VACCINATION DATE: ( yr) (1 yr) _-_ , CityTBS # _* *P e"I INCLUDE'THE CXTYTAG NUMBERIF THIS IR A RENEWAL ** (This fee is due along with Liconse Pee If raquesting at tha thho of license renewal.) Donation to ca ea for animals; _ $1 $3 ***SEE BACK OF FORM FOR eR1rEl) SPECIFIC t.IC NE SE REQUI 1ENTS — Other Do Nvt send Gash by mart TOTAL ENCLOD $ W. VISA / MC # Signature Lxpiros:..... Soourity Code: If you have questions, please convict City mail at (402) 426,4191 or by Fax: (402) 426-4195 +++++*.. *.i.++++++.. *++++t t t+.+++++# t. * .+++............................ t 4++++t.. NEW kr0YEW RESIDIENT LICENSING RFQUIREM09S(NI��i151a(�f�c���notappllcab/eJ6rr��wp ewraSidEnGsl [tsd Pets: a Mu1 wlhln 1D days w Must rtnglster Pais v�fkhln 10 acys of S (71t> at 6 months of age it tuppy/wtten re�dency. `` '