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<br />PAGE | 1 OF 2 <br /> <br />Dangerous/Potentially Dangerous Dog Registration <br />Complete this registration and return it to City Hall. Upon issuance of the registration, the city will provide the <br />owner with a uniform warning symbol provided by the commissioner of public safety to be placed on the <br />property to inform children that there is a dangerous dog on the property. The city will also provide the owner <br />with a tag to be affixed to the dog’s collar at all times identifying the dog as dangerous. The city will also add <br />the dog to a map available on our website showing the registered sites of both potentially dangerous and <br />dangerous dogs. <br /> <br />Dog owner’s name: _____________________________________________________________________ <br /> <br />Address: _____________________________________________________________________________ <br /> <br />City: ______________________________ State: _________________ ZIP code: ____________ <br /> <br />Home phone: ________________________Cell phone: _______________________________ <br /> <br />Has this dog previously been declared as potentially dangerous or dangerous in any other jurisdiction? <br /> <br />__________________________________________________________________________________ <br />Please describe the enclosure the dog will reside in and attach a site plan showing the location of the enclosure. <br />(“A “proper enclosure” per State Statue is defined as securely confined indoors or in a securely enclosed and <br />locked pen or structure suitable to prevent the animal from escaping and providing protection from the <br />elements for the dog. A proper enclosure does not include a porch, patio, or any part of a house, garage, or <br />other structure that would allow the dog to exit of its own volition, or any house or structure in which windows <br />are open or in which door or window screens are the only obstacles that prevent the dog from exiting. Chief of <br />Police or designee would determine if the enclosure is appropriate in his or her sole and absolute discretion.” <br /> <br />_________________________________________________________________________________________ <br />__________________________________________________________________________________ <br /> <br /> ☐Potentially dangerous**One-year license $500 <br />**(1) a proper enclosure exists for the dangerous dog on the premises, as well as a warning sign that there is a <br />dangerous dog on the property; <br />(2) the owner has paid an annual fee of not more than $500, in addition to any regular dog licensing fees; and <br />(3) the owner has had a microchip implanted in the dangerous dog and provided the details to the authority. <br /> ☐Dangerous**One-year license $500 <br />**To obtain a registration, the owner must present sufficient evidence that: <br />(1) a proper enclosure exists for the dangerous dog on the premises, as well as a warning sign that there is a <br />dangerous dog on the property; <br />(2) the owner has obtained a surety bond or liability insurance policy of at least $300,000, payable to any <br />person injured by the dangerous dog; <br />(3) the owner has paid an annual fee of not more than $500, in addition to any regular dog licensing fees; and <br />(4) the owner has had a microchip implanted in the dangerous dog and provided the details to the authority. <br /> <br />105