Application to erect or alter tombstone,
monument, or headstone
Please read this first
This form will be scanned by electronic equipment. It is important that you:
use a blue or black pen to complete this form; and
print clearly.
Applications must be accompanied by a permit fee. Approval is subject to compliance with the Cemeteries Bylaw.
Work cannot commence until the permit has been issued. Upon issue, the applicant is required to give 24 hours notice prior
to commencing any work.
The schedule of charges is reviewed on 1 April each year and is available from Tararua District Council Service Centres.
tararua district council 26 gordon street po box 115 dannevirke 4942 ph 06 374 4080 fax 06 374 4137 info@tararuadc.govt.nz
Ofce use only
Approved by Date
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Permit number Receipt number Invoice number
Applicant details (Please print in CAPITALS)
Agent (mason or funeral director)
Name of applicant
Address of applicant
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Phone number Fax number Mobile phone number
Email
Details of deceased (Please print in CAPITALS)
First name(s) of deceased
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Family name of deceased Date of birth
Cemetery and plot details
Dannevirke - Mangatera Norsewood Pongaroa Ormondville
Woodville Woodville - RSA Pahiatua - Mangatainoka Pahiatua - Mangahao
Eketahuna - Mangaoranga RSA Eketahuna - Marchant St Alfredton
Plot
Block
application to erect or alter tombstone, monument, or headstone2
Extracts from the Tararua District Council’s Cemeteries Bylaw
Monumental Cemetery Section
1412 Fencing, tombstones etc
1412.1 Purchasers or owners of the exclusive right of burial in any
Cemetery other than a Memorial Park or plaque Lawn Cemetery
may surround the plots of ground allotted with kerbing in
permanent materials. The highest part of such kerbing be
not more than 300mm above the highest point of the terrain.
Tombstones, headstones or other such monuments may be
erected thereon:
Provided always that no such kerbing, tombstone or other
monument shall be erected, unless a plan or description or
both as required shall have been submitted to the manager
and duly approved by them, and a permit issued therefore
on payment of the fee prescribed in the rst schedule
hereto.
1412.2 All foundations for kerbs, tombstones, headstones, monuments
and vaults shall be laid to the satisfaction of the local authority
and in compliance with sound engineering principles.
1412.3 Where an existing plot requires to be reopened or repairs
instituted and is, in part or fully enclosed in permanent materials
the plot shall be reinstated in the same permanent materials, or:-
1412.4 Removal of the existing concrete, masonry cover and kerbing is
permitted subject to compliance with the following conditions:
(i) That all concrete structures be completely removed.
(ii) A 100mm wide concrete kerb be installed to abut the
adjoining paths at the level determined by the local
authority.
(ii) The monument, headstone or tombstone be relocated at
the level and siting determined by the local authority.
(iv) The entire surface of the plot be top soiled and grassed to
the satisfaction of the Sexton. No other form of surface will
be permitted.
(v) Payment of perpetual maintenance fee as scheduled by the
local authority.
The local authority upon application and payment of fees schedule offers to
undertake the installation of kerbing, top soiling and grassing of plots.
Memorial Lawn Cemetery Section
1429 Erection of Memorials
1429.2 Concrete based work for all memorials shall not stand higher
than 150mm above the highest point of the concrete berm or
ground level, whichever is the higher, and shall be of a depth
(front to back) of 460mm and shall, where required, allow insets
for ower containers.
1429.3 The Base shall be set back 150mm from the front edge of the
concrete berm provided by Council and aligned with existing
adjoining bases if any, to the sides and rear.
1429.4 No erected memorial shall, at the head of the plot, be wider than
1m in the case of a single plot or 2m in the case of a double width
(family) plot. Memorials shall be sited, from the back edge of the
concrete berm provided by Council, 75mm to the back of the
memorial.
1429.5 The maximum height of a memorial above the concrete berm
constructed by Council shall be 600mm. Such memorial
shall comply with sound engineering principles and shall be
aesthetically acceptable to the controlling authority. The plans of
such memorial shall be submitted to, and approved by, the local
authority before the erection of any such memorial is permitted.
1429.6 No erected memorial shall be of any other material than granite
or similar material approved by the local authority. Concrete shall
be nished in white or similar cement; no coloured cements shall
be added or used.
1429.7 In constructing bases and in erecting memorials, the adjoining
roads, paths or allotments shall not be injured. Memorials are
required to be rmly xed to the platform by at least two 24mm
dia hollow dowels, or 10mm solid steel dowels.
Non compliance of this xing may result in the removal of the memorial.
1419 Deposit of Materials
1419.1 No monumental mason or other person erecting or repairing any
headstone, monument, fence or other work in, on, or around any
grave, or constructing or repairing any vault, in any Cemetery
shall make use of any footpath or other part of such Cemetery for
placing or depositing thereon any tools, planks, casks or material
in connection with the work of such erection, construction or
repair for a longer time than is reasonably necessary for the
purpose of completing such work, any such mason or other
person who, after service upon him of such a notice in writing
signed by the Clerk, requesting the removal thereof within a
specied time in such notice, shall neglect or refuse to remove
any such tools, planks, casks or material from such Cemetery
shall be liable to prosecution for any offence against this part of
the Bylaw.
1419.2 No person shall make use of any footpath or roadway in the
Cemetery for the purpose of mixing cement or mortar otherwise
than upon a proper mixing board or in other approved manner.
1419.4 The local authority requires a permit fee of $35.00 to be lodged
with every application for a permit to carry out any work.
Details of proposed tombstone, monument, or headstone
Please refer to the Cemeteries Bylaw or contact Council if you are unsure of requirements.
Materials to be used
Height (mm)
Width (mm)
Depth (mm)
Signature
I hereby apply for permission to erect a tombstone, monument, or headstone in accordance with Council’s bylaws.
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Signature of applicant Date
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signature
click to edit
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