Village of Lisle Form

2. This form should be completed by the person(s) registering a security alarm located within a private Lisle residence.
6. Applicant First Name
7. Last Name
9. Applicant Address1
11. Address 2
13. City
14. State
15. Zip
17. Applicant Phone
19. Installer First Name
20. Last Name
22. Installer Address1
24. Address2
26. City
27. State
28. Zip
30. Installer Phone
32. Description of System
34. Location of Alarm
    (Or proposed location)
36. By submitting this application, the applicant agrees that the Village of Lisle is not liable for any claimed failure of service or any consequential damages claimed to result from such failure of service. In addition, the Village of Lisle will not be liable for claims relating to the installation, surveillance or operation of the security alarm system, whether or not due to negligence of the Village of Lisle or its employees or agents. Further, the undersigned agrees to defend, hold harmless and save the Village of Lisle from any such claims arising during the term of this permit by the applicant or for claims arising during the time the alarm equipment is connected to the receiving station.
Leave This Blank:


38. 1. Receive an email copy of this form.
39. Email address

    This field is not part of the form submission.

40. Submit

* indicates a required field