Permit Applications/Information Submittal Forms

Business/Resident Name:

Address:

Zip Code:  Phone Number:

 

Business Owner/Manager Name:
Home Address: 

Zip Code:  Phone Number:

 

Business Hours:

Mon:
Tue:
Wed:
Thur:
Fri:
Sat:
Sun:

 

Emergency Contacts (Three required. List by preferred calling order):

 

First Contact:

Name:

Address:

Zip Code:  Phone Number:

 

Second Contact:

Name: 

Address:  

Zip Code:   Phone Number:

     

Third Contact:

Name: 

Address: 

Zip Code:   Phone Number:

 

Type of Alarm Site:

 

Any Weapons on Premises? Yes No

 

If Yes, Weapons Description:

Rifle Handgun Shotgun Other 

 

Where Are Weapons Kept?

 

Location of Exit Doors:N S E W NE NW SE SW

 

Alarm Installation Date:

Alarm Company Name:

Address:

Zip Code:  Phone Number:

 

Type of Alarm Installed: (check if yes):

 

NOTE: This permit is authorized for an alarm system for the above location only. Additional sites require additional permits. This permit is not intended to certify operability or effectiveness of the alarm equipment system or any portion thereof. The issuing agency reserves the right to revoke this permit for violations of any state law or ordinance relating to the operation of the alarm system.