Stansted Mountfitchet Parish Council
APPLICATION FOR PERMISSION TO ERECT A MEMORIAL AND/OR INSCRIPTION AT THE PARISH CEMETERY, CHURCH ROAD.
TO Stansted Mountfitchet Parish Council (SMPC)
FROM
DATE
Permission is sought from SPMC to
- (a) Erect a new memorial and inscription on Plot No
- (b) Add an inscription to existing memorial
- (c) Clean/restore memorial
Purchaser’s name and Address
DETAILS OF MEMORIAL
Dimensions Height Width (please provide illustration where possible)
Wording for inscription
Signature of Registered Owner of the grave space. By signing this form you agree that the Purchaser named above will have responsibility for the maintenance and safety of this memorial.
Name
Address
The proposed work to be executed at Plot No the grave of
has the approval of Stansted Mountfitchet Parish Council
Dated Signed (Clerk)
Fees payable £ Received £
The Mountfitchet Exchange, Crafton Green, 72 Chapel Hill, Stansted Mountfitchet, Essex, CM24 8AQ