Alarm User Permit Application and Information
Salt Lake County Ordinance
Address of Alarmed Premises:
(Include Suite No., Etc.)
Business or Residence Information (If Applicable)
Name:
Phone:
Mailing Address 1:
(Address)
Mailing Address 2:
(City & Zip)
Owner Information:
Last Name:
First Name:
Middle Name/Initial:
Date of Birth:
(MM/DD/YYYY)
Mailing Address 1:
(Address)
Mailing Address 2:
(City & Zip)
Home Phone:
Business Phone:
PLEASE LIST
THREE
INDIVIDUALS THAT ARE KNOWLEDGEABLE IN THE BASIC OPERATION OF THE ALARM SYSTEM AND CAN RESPOND WITHIN 30 MINUTES OF NOTIFICATION. THE RESPONDING PERSON MUST BE AUTHORIZED AND ABLE TO GAIN ENTRY AND TAKE CHARGE OF THE PREMISES IF NECESSARY.
ONE:
Last Name:
First Name:
Home Phone:
Business Phone:
TWO:
Last Name:
First Name:
Home Phone:
Business Phone:
THREE:
Last Name:
First Name:
Home Phone:
Business Phone:
Alarm Company Information
Install/Service Alarm Co:
Address:
Phone:
Monitoring Alarm Co:
Address:
Phone:
Type of Alarm:
Physical Duress
Intrusion
Both
Audible
Silent
Both
Sheriff's Alarm Coordinator
3365 South 900 West
Salt Lake City, Utah 84119
(801) 743-5766 : Fax (801) 743-5757
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