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2. READ THIS PRIOR TO COMPLETING FORM

   You can submit an Alarm User Permit application online. Payment is taken through PayPal. 

   YOU MUST SIGN-IN OR CREATE AN ACCOUNT BEFORE COMPLETING THE APPLICATION FORM. 

   If you prefer not to create an account or use PayPal, you can download and complete the Alarm User Permit Application (PDF) and return the signed application with fee to:
   Hopkins City Hall
   1010 First Street South
   Hopkins, MN 55343

4. 1. Alarmed Location
6. Street Address*
7. Apt/Suite
9. City*
10. State*
11. Zip Code*
13. Home Phone*
14. Cell Phone*
16. Work Phone*
17. Email Address*
21. Mailing/Billing Address (only if different from above)
22. Apt/Suite
24. City
25. State
26. Zip Code
30. Property Owner
32. Name*
34. Phone*
35. Alternate Phone*
39. Additional Alarm Users (or key-holders)
41. Name
43. Phone
44. Alternate Phone
46. Name
48. Phone
49. Alternate Phone
53. 2. Type of Alarm Function*

    Check all that apply

    1. Waterflow
    2. Heat/Smoke Detection
    3. Manual
    4. Burglary
    5. Panic/Medical
    6. Hold-Up
57. 3. Fee
59. Type of Alarm System
    Fire Alarm
60. Price
61. Quantity
62. Shipping Cost
64. Taxable
66. Type of Alarm System
    Police Alarm
67. Price
68. Quantity
69. Shipping Cost
71. Taxable
75. 4. Alarm Companies
77. Alarm Service Company Name*
78. 24-Hour Phone*
80. Alarm Monitoring Company Name*
81. 24-Hour Phone*
85. 5. Additional Information
    Provide any special information about the home/building (trap doors, animals or pets inside, things that may explode, chemicals on site, firearms on site, etc), lock box or key box and location.
89. 6. Authorization*

    1. I hereby authorize the Hopkins Fire Department to notify the fire alarm/sprinkler service company if a service call is necessary and my keyholder is unavailable. (Optional)
91. GOVERNMENT DATA PRACTICES - TENNESSEN WARNING
    The data you supply on this form will be used to process the license you are applying for. You are not legally required to provide this data, but we will not be able to process the license without it. The data will constitute a public record if and when the license is granted as such will be available to the general public upon written request. (MN Law M.S.13.41)
93. All alarm systems are subject to false alarm charges, fees and penalties according to City Ordinance. I have reviewed the Hopkins Alarm Ordinance and understand its contents and my responsibilities.
95. Electronic Signature Agreement*

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

    1. I agree.
97. Electronic Signature*
98. Date*
    Date
Leave This Blank:


99. Calculate Totals Proceed to Checkout

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