Alarm Permit Application

Alarm System Registration

Mount Pleasant, Tennessee
Location Type:*

ResidentialCommercial
Residential premises means any structure or combination of structures which
serve as dwelling units including single family as well as multi-family units
and churches, public schools and other non-profit organizations.

Residential Permit - $15.00 yearly

Commercial Permit - $30.00 yearly
Applicant Email:
example@example.com
Alarm Company Name:*
Alarm Company Phone:*
Alarm Type: (Check all that Apply)*

RobberyBurglaryFirePanicMedicial
Applicant Name:*
Applicant Phone:*
Applicant Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Business Address:
Business Phone:
Business Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Address To Mail Permit: (If different from above):

Street Address

Street Address Line 2

CityState

Zip Code
Special Instruction for Location (Gate Code or Access Method):
Hazardous Materials at Location:
Authorized Individuals to Contact in the Event of Alarm Activation

(List in Priority Order )
Individuals listed may need torespond to the location in the event of an emergency. If subject listed is not local to the area, please note that after the contacts name.
Authorized Individual #1:*
Authorized Individual #1 Phone:*
Authorized Individual #2:
Authorized Individual #2 Phone:
Authorized Individual #3:
Authorized Individual #3 Phone:
Authorized Individual #4:
Authorized Individual #4 Phone:
Authorized Individual #5:
Authorized Individual #5 Phone:
Authorized Individual #6:
Authorized Individual #6 Phone:
Notice: Non-Compliance with the terms in the Municipal Code shall constitute a violation, and each incidence of non-compliance shall constitute a separate violation punishable as provided in the Municipal Code Title 7 Chapter 509. For additional information, contact the Mount Pleasant Police Department (931) 379-1000 or the City's Recorders Office, (931) 379-7717.
Applicant's Signature*

Clear
Date

MonthDayYear
Date
Should be Empty:

Alarm System Registration

Authorized Individuals to Contact in the Event of Alarm Activation