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City of Sapulpa |
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FOR OFFICE USE ONLY Permit Number _____________ Date Issued________________ Amount Paid _______________ |
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425 EAST DEWEY AVE . . .P.O. BOX 1130 Sapulpa, Oklahoma 74067 BURGLARY ALARM PERMIT APPLICATION |
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City of Sapulpa |
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FOR OFFICE USE ONLY Permit Number _____________ Date Issued________________ Amount Paid _______________ |
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425 EAST DEWEY AVE . . .P.O. BOX 1130 Sapulpa, Oklahoma 74067 BURGLARY ALARM PERMIT APPLICATION |
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SUBSCRIBER/PROPRIETOR INFORMATION (
Please Print Clearly or Type)________________________________ (____) _______________________
Name of Residence or Name of Business Telephone Number At Location
Address of Alarmed Location_______________ __________ _____________________________ ________________
(One location per permit) Street No. (N,S,E,W) Street Name/Number Suite/Apt. Number
Type (Check One) Residence ______ Business ______ If Business, Normal Hours __________________________
SUBSCRIBER/PROPRIETOR MAILING ADDRESS
Attention _________________________________ Address ________________________________________
City _________________________________ State _____________ Zip __________________________
________________________________________ (_____) _________________________________________
Name of Residence or Business Owner Alternate Telephone Number of Owner
ALARM COMPANY AND/OR MONITORING COMPANY
Installed/Service by _______________________________ (____) __________________________________
Name of Alarm Company Telephone Number
Monitored by ____________________________________ (____) __________________________________
Name of Monitoring Company Telephone Number
TYPE OF ALARM (check all that apply) PREMISES INFORMATION
Burglar Alarm _____ Panic Alarm _____ Audible _____ Dogs/Animals _____ Chemicals _________
Silent _____ Date of Installation ______________ Who Owns Alarm Equipment________________
RESPONSIBLE REPRESENTATIVES
List two responsible representatives (other than the applicant) who will respond to an alarm activation to assist the Police in determining the cause of the alarm activation and to secure the premises.
___________________________________ (____) __________________ (____) __________________
Name Day Telephone Night Telephone
___________________________________ (____) __________________ (____) __________________
Name Day Telephone Night Telephone
The application fee of $20 must be included with the application. Please make check or money order payable to CITY OF SAPULPA.
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APPLICANT SIGNATURE DATE
Ordinance #2344, Passed May, 2001
