Cemetery Monument Setting Request Form

2. John Scanlon, Sexton - (316) 321-3410 - cemetery@eldoks.com

4. Monument Setting not Allowed Until Proof of Ownership or Permission From Owner is Shown

6. Regulations:

   All foundations with the exception of Walnut Valley must have a 6 inch collar. No Exceptions! Prior Approval must be obtained from the Sexton for delivery vehicles to drive on other than a designated roadway. Persons installing headstones and foundations will be responsible for cleanup of work site and removal of excavated dirt to a designated area. Monument companies must first check in with the cemetery office with payment; the Cemetery Sexton will inspect stone placement and the work site before the installers leave the cemetery grounds.

   All foundations with the exception of Walnut Valley must have a 6 inch collar. No Exceptions! Prior Approval must be obtained from the Sexton for delivery vehicles to drive on other than a designated roadway. Persons installing headstones and foundations will be responsible for cleanup of work site and removal of excavated dirt to a designated area. Monument companies must first check in with the cemetery office with payment; the Cemetery Sexton will inspect stone placement and the work site before the installers leave the cemetery grounds.

8. Must Give 48 Hour Notice (Two Full Business Days) Before Setting Monument

10. Monument Company*

12. Contact Person*

14. Contact Phone #*

16. Date Monument will be set*
    Date Monument will be set

18. Type of Monument*

    1. Pre-Need
    2. At Need
    3. Re-Set

20. Name(s) on Monument*

22. Cemetery*

    1. Sunset Lawns
    2. Walnut Valley
    3. Belle Vista

24. Block/Section*

26. Lot*

28. Space(s)*

30. Monument Setting Fee*

    1. Single - $50.00
    2. Double - $50.00
    3. Veteran - $0.00

32. Monument is*

    1. Granite
    2. Bronze
    3. Military
    4. Marble

34. Dimensions of Monument Base*

    (Length x Width)

36. Type of Foundation*

    1. Pre-Cast
    2. Wet Pour
    3. No Foundation - Walnut Valley
    4. No Foundation - Foot Marker

38. Dimensions of Foundation

    (Length x Width)

40. Vases*

    1. Yes
    2. No

42. If Yes, Number and Location of Vases

44. Comments

46. Purchaser of Monument*

48. Owner of Space(s)*

50. Deed #

52. Does the Purchaser Own the Space(s) the Monument is to be set on*

    1. Yes
    2. No

54. If No, has as the Purchaser Completely Filled Out and Returned the Monument Setting Permission Form*

    1. Yes
    2. No
    3. Purchaser Owns Space(s)

    (Cemetery Office must have a copy of this before headstone can be set)

Leave This Blank:


55. 1. Receive email copy
56. Email address

    This field is not part of the form submission.

57. Submit Submit and Print

* indicates a required field