2. Company
3. Phone Number
5. Address
7. City
8. State
9. Zip Code
11. Business Hours
12. Number of Entrances
14. Please list any hazardous chemicals on site and the location of such chemicals to assist our first responders?
16. Please list any workers at the above location that have any type of disability and the disability in order to assist on an emergency evacuation of the premises.
18. Pa. Crimes Code Section 7511 (c)(i). Control of alarm and automated dialing devices. Each business is permitted 3 false alarms within a 12 month period. Any thereafter will result in a fine (less than $300).
20. Contact Person During Daylight
21. Phone Number
23. After Hours Emergency Contact Name*
24. Phone Number*
26. After Hours Emergency Contact Name
27. Phone Number
29. After Hours Emergency Contact Name
30. Phone Number
32. After Hours Emergency Contact Name
33. Phone Number
35. Would you like to be listed in the Business Directory on the North Fayette Township website?

    1. Yes

    1. No
37. Business Email
39. Website Link Text to Read
40. Website Link
42. Description of Business*
43. Category of Business*
    -- Select One --AutomotiveCommunity GroupConstruction & ContractorsEducationEntertainmentManufacturingMedical/HealthOfficeOtherReal EstateReligious EstablishmentRestaurantRetailTravel & TransportationWarehouse
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45. 1. Receive an email copy of this form.
46. Email address

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