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Applicant s Signature Applicant s Name Printed Date Signed Date Received/Issued For Office Use Only Expiration Date Permit Arlington PD 07/2007. Please print your information clearly. Individual Permit For Single Family Dwelling Street Address to be Permitted By Mail Alarm Office 04-0101 Post Office Box 1065 Arlington TX 76004-1065 817-459-6472 Apartment Duplex Apt. Arlington Police Department Burglar Alarm Permit Application Residential Application will not be processed without an attached check or money order for 50. 00 made payable to the City of Arlington* Persons 65 do not have to pay the permit fee if the permit address is their primary residence. The permit becomes effective on the date the Police Department receives your completed application and will be mailed to the Billing Address you provide. Applicant s Full Name OR In Person 620 W* Division Street Mobile Home Zip Code Arlington Date of Birth Type New Home Phone Renewal Texas Driver s License or State ID Home Address if different from permit address City State Date Moved to Permit Address E-Mail NOTE All correspondence will be mailed to the Billing Address. A. Name of Person to Contact in an Emergency Business Phone Alarm Company Name Address include city and zip code Pets Number and Type Inside Phone Any Other Pertinent Information About the Location Confidentiality. Alarm system locations types of systems and the names of occupants at permitted locations are confidential information* The Police Department cannot disclose this information to others. See Section 1702. 284 of the Texas Occupations Code for further information* The information contained in this application is true and correct as of the date of this application* I will inform the Police Department promptly of any changes. I shall comply with all provisions of the Alarms Chapter of the Code of the City of Arlington and all applicable laws of the State of Texas. I accept responsibility for all fines and fees that may result from the operation of the alarm system for the premises named in this application and shall pay all costs expenses and attorney s fees incurred or paid by the City of Arlington for the collection of such fines or fees. Arlington Police Department Burglar Alarm Permit Application Residential Application will not be processed without an attached check or money order for 50. 00 made payable to the City of Arlington* Persons 65 do not have to pay the permit fee if the permit address is their primary residence. 00 made payable to the City of Arlington* Persons 65 do not have to pay the permit fee if the permit address is their primary residence. The permit becomes effective on the date the Police Department receives your completed application and will be mailed to the Billing Address you provide. Applicant s Full Name OR In Person 620 W* Division Street Mobile Home Zip Code Arlington Date of Birth Type New Home Phone Renewal Texas Driver s License or State ID Home Address if different from permit address City State Date Moved to Permit Address E-Mail NOTE All correspondence will be mailed to the Billing Address. A. Name of Person to Contact in an Emergency Business Phone Alarm Company Name Address include city and zip code Pets Number and Type Inside Phone Any Other Pertinent Information About the Location Confidentiality.