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Security Alarm Application

Security Alarm Application

Permit #   New Application  Revised Application    Date of Application 

Type of Alarm:  Business Intrusion Alarm   Residential Intrusion Alarm   Business Hold-Up Alarm
             Residential Panic Alarm   Business Fire Alarm        Residential Fire Alarm

Address of Alarm System:
, North Kansas City, MO 64116 - 

Alarm User Information:
Name 

Address 

Home Phone   Work Phone  Ext   Cell Phone 

Local Business Agent or Resident - This must be the person to sign the application and be responsible for the violation(s):
Name 

Date of Birth   Race   Gender 

Address 

Business Relation 

Home Phone   Work Phone   Ext   Cell Phone 

Contact - Someone at another address to be contacted if necessary
Name 

Address 

Home Phone   Work Phone   Ext   Cell Phone 

Property Owner/Agent:
Name 

Address 

Home Phone   Work Phone   Ext   Cell Phone 

Alarm Information:
Date Installed or Took Possession   Serviced by: Installer  Other (If Other, specify below)
      Name 
      Address 
      Work Phone   Ext 

Monitored By:
Company Name 

Type of System 

 

Name of business agent or resident completing this alarm application 

 

 



Security Measure

City Hall
2010 Howell St
North Kansas City, MO 64116

Phone 816-274-6000

Regular Hours:
Monday - Friday
8am to 5pm

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