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APPLICATION FOR MEMORIAL PERMIT - TO ERECT A NEW MEMORIAL OR REPAIR AN EXISTING MEMORIAL

To: Orkney Islands Council, Burial Grounds Officer, Infrastructure & Organisational Development, School Place, Kirkwall, Orkney, KW15 1NY

Telephone: 01856 873535
Email: burialgroundsofficer@orkney.gov.uk

A memorial permit application fee must be paid if the application is for a new memorial. There is no charge for repairing existing memorials. Payment can be made over the phone with Customer Services (01856 873535) or online at https://orkney-self.achieveservice.com/service/Memorial_Permit_Payment

Memorials are inspected on a rolling programme. Orkney Islands Council reserves the right to take whatever action is necessary to ensure the memorial is maintained in a safe condition and will not be liable for any damage that occurs in this process.

IMAGE: The first page is an Orkney Islands Council memorial permit form. It includes the Orkney Islands Council crest and name, the completed cemetery details “St Olafs”, section “45”, lair number “12”, and customer, memorial and stonemason information. The form shows “ERECTING A NEW MEMORIAL” marked with an X and “REPAIRING AN EXISTING MEMORIAL” unmarked. Red instructions indicate which fields should be completed by the customer and stonemason.

Cemetery and lair details

FieldInformation
CemeterySt Olafs
Section45
Lair No12

I, below, being the person entitled to Exclusive Right of Burial in the above lair understand that the safe erection and maintenance of this memorial is my responsibility.

Applicant details

FieldInformation
Applicant Name (Please Print)JAMES EXAMPLE
Address (Inc. Postcode)123 Example Street, Kirkwall, KW15 2NE
Relationship to DeceasedBrother
SignatureSigned
Contact No07782 346889
Email Addressjexample@gmail.com

Memorial work

Type of workSelection
ERECTING A NEW MEMORIALX
REPAIRING AN EXISTING MEMORIAL

Memorial details

FieldInformation
Size of Memorial (cm): Depth10cm
Size of Memorial (cm): Width50cm
Size of Memorial (cm): Height90cm
Memorial MaterialGranite
Memorial ShapeStandard lawn
Name of Deceased or Proposed InscriptionJANICE EXAMPLE
19/02/47 - 22/03/25
Age 78
Beloved wife, mother and sister

I, below, have been instructed to carry out the memorial work, a full description is submitted with this form, the applicant has seen and approved these. An approved permit will be in my possession before works begin. I confirm this memorial will be installed to meet BS 8415:2018 standard.

Stonemason details

FieldInformation
Name and address of Council approved stonemasonBarry Mason, 45 Chisel Close, Kirkwall, KW15 1BR - tel: 07546 907778
Signature of stonemasonSigned
Date30/04/2025
Planned date of completion05/05/2025
Actual date of completionFilled in by council once notified by stonemason

USE REVERSE FOR ANY ADDITIONAL REMARKS

Office use only

FieldInformation
Date Received
Permit Approved By
Reference Number
Council recordStatus
Permit details added to register
Correct lair identified
Permit paid
Approval sent
Notified work complete
Inspected by OIC
Inspection records updated
Memorial added to plot plan

ANY ADDITIONAL REMARKS:

IMAGE: The second page contains a blank “ANY ADDITIONAL REMARKS:” box, followed by the heading “Process for submitting, approval and payment of permits”, six numbered instructions, and the heading “Privacy Statement”. The footer reads “Version 10/2025”.

Process for submitting, approval and payment of permits

  1. Customer agrees memorial design and proposed inscription with stonemason.

  2. Customer ensures lair and contact details are correct on permit form, signs and passes to stonemason.

  3. Stonemason fills out remainder of permit form, signs and submits to Council. If the memorial is of a non-standard design, an accompanying sketch must be submitted.

  4. Council processes permit form and contacts customer to inform that payment can be made over the phone with Customer Services (01856 873535) or online at https://orkney-self.achieveservice.com/service/Memorial_Permit_Payment.

  5. Once payment received, permit issued to stonemason to carry out work.

  6. Once work complete, stonemason must inform the Council. Memorial will then be inspected after 28 days.

Privacy Statement

The personal information provided on this form will only be used as a means of contacting the lair owner/next of kin to discuss the application or inform of any irregularities or damage that may have occurred to their memorial - or if the memorial has failed a safety inspection.

The information will not be shared with any third party organisations other than the stone masons responsible for erecting the memorial. It will be retained as part of the Council's memorial installation and inspection records.

Version 10/2025