Emergency Notification Card - Wheaton Police Department

Please provide the information requested below at the time a Certificate of Use and Occupancy is issued, it will be forwarded to the Police Department and maintained on file by the City for utilization for emergency purposes only and is kept confidential. Should any of this information change, please fax the corrected information to the Wheaton Police Department at 630-260-2154.

Completed or Revised on:                                                              

Business Name:                                                                              

Address:                                                                                          

Phone:                                                                                            

PERSONS TO BE NOTIFIED

  1.                                                   Phone:                                        
  2.                                                   Phone:                                        
  3.                                                   Phone:                                        

Received by:                                     Date:                                          

             Officers of the Wheaton Police Department have my approval to conduct an inspection of my business premises without my presence or that of my agent in the event that the premises is found unsecured after business hours.

             Officers of the Wheaton Police Department do not have my approval to conduct an inspection of my business in the event that the premises is found unsecured and I understand that the officer(s) may not remain at the premises until my arrival or that of my agent at the premises.

                                                                              
Name of Owner/Manager - please print or type

                                                                              
Signature of Owner/Manager

This information will be stored in a secure database that can be accessed by authorized users from other City of Wheaton Depts. for official use only.
Date:                                

Revised 4/17/2020