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Yorkton City Cemetery Monument Permit Application

Monument Permit Application

306-828-2451

APPLICANT

*The applicant certifies that they are the current owner/license of the burial plot, or is the authorized decision-maker as per The Funeral and Cremation Services Act.

Applicant's First Name:

Applicant's Last Name:

Address:

City:

Province:

Postal Code:

Applicant's Phone Number:

Applicant's Email Address:

MONUMENT COMPANY

Name of Monument Company:

Monument Company Contact Name:

Monument Company's Email Address:

Monument Company's Phone Number:

Address:

City:

Province:

Postal Code:

SITE INFORMATION

"The Hill" means the section in the Cemetery defined as Block 1 through to Block 27.
"The Meadow" means the section in the Cemetery defined by Block 27A through to 38.
"Woodland Path" means the naturalized cremation area within the wooded areas of The Meadow and defined as Blocks 36 and 38.

To install a monument in:

Block:

Lot:

Plot:

Inscribed Name(s):

MONUMENT INFORMATION

Material for Die:

Material for Base:

Material for Foundation:

Please attach a rendering of the monument.

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Allowed extensions pdf, doc, docx, xls, xlsx, jpg, jpeg, gif, png, tif

Monument Notes:

MONUMENT DIMENSIONS

Die Measurements

Depth:

Width:

Height:

Base Measurements

Depth:

Width:

Height:

Foundation Measurements

Depth:

Width:

Height:

ACKNOWLEDGEMENTS

I acknowledge the following regulations from the City of Yorkton Cemetery Bylaw:

That no monument or markers for the purpose of designating plots shall be installed in the Cemetery unless such monuments or markers have first been submitted to and approved by the Director and a permit issued for the installation of same.

That as per the City of Yorkton Cemetery Bylaw, any monument company, its employees, contracted employees thereof and/or authorized individuals carrying out any monument work in the City Cemetery must present a copy of this permit to the caretaker upon arrival at the Cemetery and shall be responsible for the restoration and repair of any damages to the Cemetery grounds or fixtures resulting from their actions.

That the City of Yorkton will not be held responsible for any monument damages or repairs required due to improper installation of the above noted monument.

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Yorkton City Cemetery Monument Permit Application

Monument Permit Application

306-828-2451