Alarm Permit and Business Information forms are due at the beginning of every year as well as any time information on the business changes.  It is important that the Police Department has updated information at all times.  You can complete the form online, print the form out to bring in, fax, or mail, or you can come to the Police Department and pick a form up.

INSTRUCTIONS AND INFORMATION FOR ALARM PERMIT USERS

• The permit holder must be an individual.  Company names only are not allowed.
• Please include apartment numbers, complete with zip code, and telephone area code.
• Two additional contact persons are required in the event the permit holder cannot be contacted.

PERMIT RENEWAL DUE EVERY JANUARY 2

EXCESSIVE FALSE ALARM FEES

There is no service fee for the first three (3) false alarms within a 12-month period.   After the fourth (4th) false alarm, a municipal court citation will be issued for permitting more than three (3) false alarms within a 12-month period.

Section 207.010 B of City Ordinance 02-34 states:  “Upon the reception of a third false alarm within any 12-month period, the Police or Fire Department shall issue a written warning notice to the owner or lessee of the premises involved.  The owner or lessee shall file a written report with the Police/Fire Department within five (5) working days indicating any and all measures taken to reduce false alarms.”

Section 207.010 D. states:  “Anyone convicted under the provisions of this ordinance with having permitted at least four (4) police/fire responses to false alarms within any twelve (12) month period shall, in addition to being subjected to any fines ($30.00 per incident as per City Ordinance 02-34) or other punishment imposed in any Municipal Court proceedings, cause such alarm or alarm system to be disconnected, and it shall be unlawful to reconnect, or fail to disconnect, such alarm or alarm system….”

PERMIT HOLDER SHALL INSURE THAT:

1. The Police Department is furnished current information.
a.   All fire alarm permits are renewable January 2nd of the each year without charge.
b. Any changes shall be filed within 10 days after any change in the information     contained in the original application.
c. Upon timely filing of an amended application, a new alarm permit shall be issued without the imposition of any fee or charge (decals will be issued only once or to replace a damaged one).
2. Fire alarm systems shall have a maintenance contract for testing and inspections in accordance with National Fire Protection Association standards.  Copies of maintenance contract and test results of the fire alarm system shall be forwarded to the Fire Chief within 30 days from date of test.
3. The Permit Number is provided to their alarm and/or monitoring company.
4. No alarm or alarm system designed to transmit emergency messages shall be tested or demonstrated without first notifying the Police Department and the Fire Department.
5. The owner or lessee of any alarm or alarm system shall provide response to the alarm location, when requested, in order to rest or disable alarm or alarm system within 1 hour of notification.
6. All alarms having audible or visual signal at the premises shall be so equipped so as to automatically shut off after 15 minutes except those alarms required by law to have a longer operating period, in which case the system shall be so equipped as to automatically shut off the audible or visual signal at the conclusion of the longer required operating time.
7. The alarm mechanism is maintained in good working order at all times to suppress false indications due to:
a.  Short flashes of light,
b. Wind,
c. Noises,
d. Vehicular noise or,
e. Other forces unrelated to an actual emergency.

For further clarification of the ordinance you may call:        
Republic Police Department (417)732-3900

Apply for an Alarm Permit

City of Republic, Missouri
Alarm Permit Application and Business Information

Permit is renewable annually on January 2nd.

Permit Number (if existing) Invalid Input	Date of Application (*) Invalid Input
New or Renewal? (*) NewRenewal Invalid Input
Address where alarm is located (Street & Apt/Suite #) (*) Invalid Input
Daytime Phone Number (*) Invalid Input	Nighttime Phone Number (*) Invalid Input
City (*) Invalid Input	State (*) Invalid Input	Zip Code (*) Please input a valid 5 digit ZipCode.
Business Name (if applicable) Invalid Input
Alarm User (Person) Responsible for System:
Name (*) Invalid Input	Mailing Address (if different) Invalid Input
City Invalid Input	State Invalid Input	Zip Code: Invalid Input
Daytime Phone Number (*) Invalid Input	Nighttime Phone Number (*) Invalid Input
Emergency Contacts: Must be able to respond within 30 minutes, have access to premises and ability to reset system.
Emergency User 1 Name (*) Invalid Input	Emergency User 1 Phone (*) Invalid Input
Emergency User 1 Type (*) homecellpagerworkother Invalid Input
Emergency User 2 Name Invalid Input	Emergency User 2 Phone Invalid Input
Emergency User 2 Type homecellpagerworkother Invalid Input
Emergency User 3 Name Invalid Input	Emergency User 3 Phone Invalid Input
Emergency User 3 Type homecellpagerworkother Invalid Input
For additional emergency users, please specify their name, phone number, and type of number at the bottom of this sheet in the 'additional information' area.
Person or Entity Providing Alarm Maintenance/Repair Service
Name Invalid Input	Address Invalid Input
City Invalid Input	State Invalid Input	Zip Code Please insert a valid 5 digit Zip Code.
Phone Number Invalid Input
Business that is Monitoring Alarm System
Business Name Invalid Input	City Business License Number Invalid Input
Address Invalid Input
City Invalid Input	State Invalid Input	Zip Code Please use a valid 5 digit Zip Code.
Contact Name: Invalid Input		Phone #: Invalid Input
Type of Alarm Audible Only Silent (signals alarm monitoring company) Both Audible/Monitored Burglary Robbery Fire Medical Emergency Invalid Input
Special Instructions/Hazardous Materials or Conditions on Premises: (please include any information which might be useful to the police department when responding to alarms at this address).
Additional Information Invalid Input
Submit a separate application for each alarm system. By signing or typing my name below, I hereby certify that I am the owner or designated agent for the owner of the Alarm Site shown above and that the above information is true and correct. I understand that my alarm system is governed by City Ordinance Chapter 207, and its provisions. I understand that I will be responsible for timely payment (within 30 days) of fees incurred should the Police/Fire Department respond to more than three (3) false alarms within a consecutive 12 month period. I also understand that I may be liable for all expenses incurred by the City in disabling my alarm system, if the alarm system emits an audible signal for longer than 30 minutes. Further, it is my responsibility to notify the City, within 10 working days, of any changes in contact personnel.
Your Name (Digital Signature): (*) Invalid Input	Todays Date (*) Invalid Input
If not submitting digitally by pressing 'Submit Application' below, you can mail or bring this form to: Republic Police Department 540 Civic Boulevard Republic, MO 65738
Please send replacement decal Invalid Input	Please indicate where alarm permit will be displayed Invalid Input
For questions on this form, please contact the Republic Police Department at (417)732-3900, or you may also fax the completed form to (417)732-3991.

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