Alarm User Permit Application - City of York, Nebraska

URL

This field is for validation purposes and should be left unchanged.

Date of Application

Name of Business or Residence(Required)

Address(Required)

Street Address Address Line 2 City State ZIP Code

Phone

Mailing Address

(If different than above)

Street Address Address Line 2 City State ZIP Code

Name of Alarm Company

Alarm Company Phone

Address of Alarm Company

Street Address Address Line 2 City State ZIP Code

Primary Contact

Primary Contact First Name

Primary Contact Last Name

Primary Contact Phone

Primary Contact Cell Phone

Primary Contact Address

Street Address Address Line 2 City State ZIP Code

Secondary Contact

Secondary Contact First Name

Secondary Contact Last Name

Secondary Contact Phone

Secondary Contact Cell Phone

Secondary Contact Address

Street Address Address Line 2 City State ZIP Code

Third Contact

Third Contact First Name

Third Contact Last Name

Third Contact Phone

Third Contact Cell Phone

Third Contact Address

Street Address Address Line 2 City State ZIP Code

Annual Fee

Single Family Dwelling: $10.00 annually
A building having accommodations for and occupied exclusively by one family. This may include modular homes, manufactured homes, and mobile homes.

Non-single Family Dwelling: $25.00 annually
Any building that does not qualify as a single family dwelling.

Select your Dwelling Option(Required)

Single Family Dwelling: $10.00

Non-single Family Dwelling: $25.00

Special Considerations

Physical needs, vicious animals, safe, hazardous materials, etc.

After submitting, the form will be processed by the YPD

Checks may be dropped off during business hours and credit card payments can be done in person or by phone (402-363-2640).

After the payment has been processed and payment is received the license and/or permit will be mailed/emailed to you.

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