Listen

Online Form - Monument Permit Application

Details of Deceased

Name:*

Date of Death:*

Date of Burial:*

Grave Details

Denominational Ground:*

Section:

Plot:*

Grant of Right of Burial Details

Holder of Grant Name:*

Holder of Grant Address*

Date Issued:*

Please Upload a Copy of the Grant and Written Consent from Grant Holder:*

Max File Size: 10.00 MB
Allowed File Types: .avi, .doc, .docx, .gif, .jpeg, .jpg, .mov, .mp3, .mp4, .mpeg, .mpg, .pdf, .png, .ppt, .pptx, .xls, .xlsx

Monument Permit Application

Name of Company:*

Address:*

Contact Person:*

Contact Number:*

Email Address:*

Quoted Cost:

Date of Quote:

Nature of Work

Please Note:
All monuments must conform to the Pinjarra Cemetery Local Law 2006.
All Monuments should be constructed to a standard that lasts for a period of 50 years (GROB and Renewed GROB).

The project will entail:*

Adding further inscription
Renovating or Adding Further Work
Installing a New Monument/Memorial
Other

Please Upload Plans and Specifications:*

Max File Size: 10.00 MB
Allowed File Types: .avi, .doc, .docx, .gif, .jpeg, .jpg, .mov, .mp3, .mp4, .mpeg, .mpg, .pdf, .png, .ppt, .pptx, .xls, .xlsx

Name of signatory:*

Date:

Type the code from the image:

Get Audio Code

Type the code from the image