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Monument Foundation Request Form

  1. Purchaser Contact Information:

    Grave plot owner or relation completes this section.

  2. Monument Company Contact Information:

    Vendor creating & delivering grave marker completes this section.

  3. Cemetery Location
  4. Complete one of the following below:

    Foundations are $0.55 per square inch.

  5. Dimensions for SINGLE Foundation:

    Foundation dimensions not to exceed 40"x16" (including Foot Markers & Cremains Sections).

  6. (Fndn Length x Fndn Width x $0.55)

  7. Foot Marker (flush)?*
  8. Dimensions for DOUBLE Foundation:

    Foundation dimensions not to exceed 62"x16".

  9. (Fndn Length x Fndn Width x $0.55)


  10. Foundations typically poured Memorial Day through Labor Day, weather dependent.

    Make checks payable to "City of Portage".

  11. If you have any supplemental information you would like to provide as a part of this request (i.e. drawings, orders, etc.) please add them below:

  12. Office Use Only:
  13. Leave This Blank:

  14. This field is not part of the form submission.