Cemetery Permit | City of La Cygne

Name/Company

First

Last

Company

Date of Application

Address

City/Town

State/Province

ZIP/Postal Code

Phone

Fax

Name of Deceased

First

Middle

Last

Suffix

Birth Date

Death Date

Cemetery

Oaklawn

Pollman

La Cygne

Unknown

Section or Block / Lot / Grave

Description of work to be performed:

I agree to the terms of service.

Cemetery Regulations

• Before any memorials or marker work is started in the cemetery by anyone, a permit shall be obtained from the City Hall.
• Any memorial/marker which is not set according to the rules and regulations of the cemetery will be corrected by the contractor at the contractor’s expense and contractor will not be issued any permit for future work until such correction is made.
• Monuments/Markers Installation: Monuments and markers shall be placed on a minimum of ten (10) inch depth concrete, the same length and width of the base of the monument/marker; shall have a minimum of two (2) concrete cores extending a minimum of the height of the monument or thirty-six inches, whichever is greater, below the bottom of the foundation; having at least one (1) core for every eighteen (18) inches of the length of the monument/marker base.
• Foundations shall be washed after setting to eliminate rough visible cement and all cement is to be kept level at the elevation of the existing grade. A common foundation will be allowed for two or more memorials/markers on the same lotor more than one grave space.

I acknowledge that I have reviewed this application in its entirety and all information is true and accurate to the best of my knowledge.