INFORMATION ON DECEASED
INFORMATION ON DECEASED ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ INFORMATION ON APPLICANT INTERNAL USE ONLY Cemetery Name: Location of Burial Site: Type of Burial: OD Earth Burial OO Vault C2 Crypt [] Cremation ee Total Amount Due: $ Permit Fees Collected: $ Check # if applicable Receipt # Department of Health Burial Permit # Date The Lynsbuste ible [nares DEPARTMENT OF PUBLIC WORKS UNITED STATES VIRGIN ISLANDS USVI Department of Public Works Burial Plot Permit Application
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INFORMATION ON DECEASED ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ INFORMATION ON APPLICANT INTERNAL USE ONLY Cemetery Name: Location of Burial Site: Type of Burial: OD Earth Burial OO Vault C2 Crypt [] Cremation ee Total Amount Due: $ Permit Fees Collected: $ Check # if applicable Receipt # Department of Health Burial Permit # Date The Lynsbuste ible [nares DEPARTMENT OF PUBLIC WORKS UNITED STATES VIRGIN ISLANDS USVI Department of Public Works Burial Plot Permit Application