Burlington, IA

Alarm Permit Application

Steps

1. Step One This section is complete This section is incomplete
2. Contact Persons (must be able to respond and assist Police - list must be kept current) This section is complete This section is incomplete

Step One

Alarm Site Address
City
State
Zip
Alarm Company
Telephone Number
Alarm Type*
1. Intrusion
2. Hold Up
3. Fire
Permit Holder First Name
Permit Holder Last Name
Business Name (if applicable)
Billing Address
City
State
Zip
Telephone Number (primary)
Telephone Number (secondary)
Driver's License Number (including State)
Email Address
Continue

Contact Persons (must be able to respond and assist Police - list must be kept current)

Primary Contact First Name
Primary Contact Last Name
Phone 1
Phone 2
Phone 3
Secondary Contact First Name
Secondary Contact Last Name
Phone 1
Phone 2
Phone 3
Your electronic signature below indicates your agreement with the following statements: By typing my name in the following box and clicking submit button I certify the above statements to be true and correct, to the best of my knowledge and hereby agree that if a permit is issued, I will comply with all provisions of the City Code and applicable State laws. I accept responsibility of payment of all fees and fines that may result from the operation of the alarm serving the above premises.
Your electronic signature below indicates your agreement with the following statements: By typing my name in the following box and clicking submit button I certify the above statements to be true and correct, to the best of my knowledge and hereby agree that if a permit is issued, I will comply with all provisions of the City Code and applicable State laws. I accept responsibility of payment of all fees and fines that may result from the operation of the alarm serving the above premises.
Date
Date
Permit Holder Signature
The permit application is renewed annually by July 1st. Renewal notices are mailed and/or emailed, however it is the responsibility of the permit holder to ensure that the permit is renewed if a notice is not received. If you have any questions, please contact the Burlington Police Department between 7:30 a.m. and 4:30 p.m., Monday through Friday at 319-753-8355.

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Alarm Permit Application

Steps

Step One

Contact Persons (must be able to respond and assist Police - list must be kept current)

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