Memorial Seating Application Form (with or without memorial plaque)

MEMORIAL SEATING APPLICATION FORM

(WITH OR WITHOUT MEMORIAL PLAQUE)

For further information or questions regarding this form, please contact Council via 9911 6555.

Fees and Charges for each option on this form are as per the 'Memorial Donations' section of Council's Fees & Charges.

Conditions

The following conditions are intended to fully inform potential applicants. Additional requirements and conditions maybe applicable depending on the nature of each application and legal requirements:

All applicants will be considered on merit and be subject to the published fees and conditions
Additional fees will be levied where site conditions dictate or additional installation requirements are necessary
Council retails the right to refuse any application which it considers inappropriate
All installations will be carried out by Council or its nominated contractors. Council will not permit installation by applicants or their contractors under any circumstance
The 3mm engraved brass memorial 140mm x 55mm mountable on the seats slats is the standard provided with the extent of wording permitted to be in accordance with a standard template
The seat provided is a Furphy Foundry Gov 20 in black
The general installation standard provided is in accordance with the photograph available at Customer Service
The reinforced concrete platform on which the seat is mounted is 2400mm x 1200mm
The seating installation on offer is of a standard nature and variations on the materials and installation design will not be considered except where site conditions dictate exceptional circumstances
The final location of the installation and seating orientation will be determined on site with the applicant
Council will not be responsible for the replacement of seats, plaques or concrete works which are vandalised, damaged or stolen. Standard maintenance activities such as graffiti removal will however be undertaken as required
Seating which reaches a dilapidated condition will be removed. The estimated asset life of a seat in a park is10 years
Council retains ownership of the installation at all times
A minimum of 2 months is to be allowed for Councils to undertake the installation following receipt of full payment
No works will be undertaken until full payment is received

Applicant details

Surname *

First Name *

Email *

Contact number *

Company name

Address *

Postcode *

Plaque details

Please indicate what you are applying for *

Memorial Seat with Plaque Park seatMemorial plaque only (to be placed on existing bench)

The wording I wish to place on the plaque is: *

Reasons for placement of plaque in memory of a long term resident or to recognise someone who has lived in City of Canada Bay or contributed to the City of Canada Bay community over many years: *

The preferred location of the park bench and plaque is: *

Please attach a photograph or sketch of location *

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Applicant Signature (1) *

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Applicant Signature (2)

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Date signed *