All marker permits must include a photograph, sketch, or other accurate depiction or rendering, to
include all applicable materials, dimensions, and wording. Please allow 24 hour notice for all permit
requests. Incomplete permits will not be accepted.
Grave Marker or Memorial For:
Cemetery:
Headstone/Footstone/Ledger
Marker/Monument Size
Width
Length
Height
Material
Upright/Flush Marker
If Upright, base included?
If yes, size of base:
Permit Installed By:
Installer’s Address:
Contact Information:
Phone No.
Fax No.
Requested Installation Date:
Time:
Installation Authorized By:
(Owner or Authorized Representative)
Section Plot Grave
Work Order No.:
Cemetery Plot Owner of Record:
Town Approval
(Public Works Director or Authorized Representative)
Date:
Inspected By:
Date:
Comments:
TOWN OF CLAYTON
Operations Center
653 Highway 42 West, Clayton, NC 27520
P.O. Box 879, Clayton, NC 27528
Phone:
919-553-1530
MARKER INSTALLATION PERMIT
June 2014
click to sign
signature
click to edit
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