| Type Permit Requested: | |
| Alarm Use: | |
| Permit Applicant Information |
| Business or Homeowner Name: * | |
| Email: * | |
| Type of business conducted: | |
| Days and Hours of Operation: |
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| Phone at Alarm Location: * | |
| Alarm Site Physical Address |
| Street Address: * | |
| Suite or Apartment #: | |
| City, State: * | |
| Zip: * |
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| Applicant Information |
| Applicant Name: * | |
| (Mailing Address If Different From Above): | |
| City, State: | |
| Zip: |
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| Any dangerous or special conditions present at the alarm site: |
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| Alarm System Information (You must check all boxes for alarm registration to be valid): |
| I have been given written operating instructions for the alarm system, including written guidelines on how to avoid false alarms. * | |
| I have received training from the alarm company in the proper use of my alarm system, including training in how to avoid false alarms. * | |
| I understand that law enforcement response may be based on factors such as availability of Police units, priority of calls, weather conditions, emergency conditions, staffing levels, etc. * | |
| Monitoring Company Information |
| Name: | |
| Street: | |
| City, State: | |
| Zip: | |
| Phone: | |
| Responsible Parties to be Notified (Note: Parties must be willing to respond 24/7 to any alarm issues) |
| Contact Name #1: * | |
| Home Phone #1: * | |
| Work Phone #1: * | |
Cell/Pager Phone #1: | |
| Contact Name #2: * | |
| Home Phone #2: * | |
| Work Phone #2: * |
|
| Cell/Pager Phone #2: |
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| Contact Name #3: | |
| Home Phone #3: | |
| Work Phone #3: |
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| Cell/Pager Phone #3: |
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| Comments or Special Circumstances: |
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(* Required Fields) If you have any questions about alarm registration, please contact us. |