Section 1 - Alarm Location & Type Information

Address:

City:

Zip:




Address:

City:

State:

Zip:


 

 

(Hazardous Materials, Fire Arms, Etc.)


Section 2 - Business or Resident Information Business Alarm Information  (If your alarm is located at a business, fill out the next 2 lines)






Residential Alarm Information  (If your alarm is located at a residence, fill out the next line)


 
Section 3 - Persons to be notified when alarm sounds (We will contact in order shown)












 
Section 4 - Alarm Company / Central Station Information









Section 5 - Owner / Agent Agreement
This application is made by me with the understanding and agreement that I will abide by all provisions of the Lincoln County Alarm Ordinance. I understand that failure to comply may result in termination of my alarm permit, as provided by law.
 
 
By the initials above I certify that the above information is true and accurate to the best of my knowledge.



After submitting this application you will be taken to a form for payment.