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Memorial Permit Application

Please ensure you have completed the Fillable PDF form to complete your online application.

Applicant Information

Full Name

Primary Phone Number

Email Address:

Mailing Address

Type of Memorial

Please select one

Flat Marker Permit

$80.00

Upright Monument Permit

80.00

Columbarium Niche Plate Permit

80.00

Memorial Wall Inscription

620.00

Statement of Applicant

I confirm that I have read section 9 of City of Cold Lake Bylaw No. 677-AD-20, Cemetery Management Bylaw and Schedule “C” of City of Cold Lake Policy No. 207-AD-19, Cemetery Management Policy which provides the Memorial Regulations.

I certify that the information I have provided on this application is true to the best of my knowledge.

I agree to the above statement

Yes

To complete the memorial permit application, click here. (Fillable PDF)

Once you have completed your form, save the completed form and upload the PDF here.

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Allowed extensions pdf, doc, docx, xls, xlsx, jpg, jpeg, gif, png, tif

Please upload any renderings of your memorial here.

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Allowed extensions pdf, doc, docx, xls, xlsx, jpg, jpeg, gif, png, tif

Information on this form is collected for the sole use of the City of Cold Lake and is protected under the authority of the Protection of Privacy Act, Sec. 4 (c), which regulates the collection, use, and disclosure of personal information.

If you have any questions or concerns, please contact the ATIA Coordinator by email (legislative@coldlake.com) or phone (780) 594-4494 ext. 7915.