Application to Erect Cemetery Monuments
This form is to be used to apply for erection of all monumental work in the cemeteries of Yass Valley Council.
Applicant and Owners Details
Company Carrying out Works
Company Name
*
Contact Name
*
First Name
Last Name
Postal Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Please enter a valid phone number.
Email
*
example@example.com
Applicants Signature
*
Client Name
*
Who is the work being done for
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Please enter a valid phone number.
Location and Description of Work
Cemetery
*
Lot(s)
*
Section
*
Name of Deceased
*
First Name
Last Name
Description of Work
*
Material
*
Size
*
Inscription
*
Please attach a sketch of footing and monument construction
*
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of
Insurance and Licence Information
Public Liability Insurance
*
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Cancel
of
Plant/Vehicle Insurance
*
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Required for all vehicles entering cemetery grounds
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of
Stonemason Licence No
*
Note: All Memorials must be constructed per Australian Standard AS4204
Application Fee
Application Fee
*
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Application Fee - Erect Cemetery Monument
$
130.00
AUD
Quantity
1
2
3
4
5
6
7
8
9
10
Credit Card Details
First Name
Last Name
Credit Card Number
Security Code
Card Expiration
Submit
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