Prairie Lawn Cemetery Monument Request
Please complete this form in its entirety.

Submit this form at least 2 full business days before you would like to set the monument.

There is no permit fee for VA markers. A Monument permit fee of $30 shall be charged for each monument/marker with the exception of VA markers. All holes must be inspected before concrete can be poured, no dry mix will be allowed. The concrete apron must extend 6 inches beyond the monument and/or any vases. the foundation cannot exceed 4 feet in length on a single lot, or 8 feet in length on 2 lots. Forms must be removed and back-filling completed within 2 weeks of monument setting. All benches, statues, private columbariums, and private mausoleums must be pre-approved by the Cemetery Sexton.

If you need assistance with Lot Ownership or locations please feel free to contact the Cemetery or City Clerk's Office, any other questions may be directed to the Cemetery Office.
Cemetery Office 620-326-7937
City Clerk 620-326-2811, 620-399-1351
Monument Company *
Contact Person *
Contact Phone # *
Date monument/marker will be set *
MM
/
DD
/
YYYY
Name(s) on monument *
Last Name, First Name(s)
Block *
Lot(s) *
Monument will be set on: *
Required
Dimensions of Monument Base: *
Enter in Length x Width x Height
Die:
If applicable, Enter in Length x Width x Height
Dimensions of Foundation: *
Enter in Length x Width
Vases *
Number of Vases
Only if answered yes to vases
Location of Vases
Only if answered yes to vases, if placed at ground level concrete must extend 6 inches beyond all sides of the vase.
Owner(s) of Lot(s): *
Does the purchaser have proof of ownership or permission for monument placement? *
Monuments will not be set on lots without permission from lot owner.
Submit
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