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Sweeney, Ida • Cemetery Call Work Sheet Date: I l .2S-1 o7 Funeral Home/ Monument Company: M o kK Fu.?.. A<X Contact Name: BI M? Tel. #: 393- 3yg I I+.?er? n??e Reason for call: For- Fax #: 3 °f 8- (.19413 A-SL4 - ur,. Deceased Name: 1Ua- Sw c e n e Date of Birth: 0?-/ 10 / I Q Date of Death ° S / to / 113 ft, Block I Lot Space 3)y 04_ rw2.Q bwaa A 3, • (???? £. $wc?Key) Owner of Plot: Ic2a- Swe ewe ******************************************* ******************************** ******************* Interment: (One full burial and one urn, or two urns per space) Full Burial Urn Space ? - a S rg ; $30.00 Staking Fee - received on: Date of Burial: Time: am/pm ?Lt? ?wu w4, w? ?2 fir Disinterment: c, ? a&j f.? N &-%-e- . The following authorization should be obtained prior to disinterment: ?R 1.) A disinterment permit and burial/cremation transit permit 2.) Written authorization from the individual(s) who currently own the burial rights for the plot; and 3.) Written authorization from the individual(s) who would be permitted to authorize burial Monument Being Placed: (No Fee for Staking of Monument) 0 I/a-14-7 /??V iS c.? N1?-. l?? ?, l Nta ?k ?`'«ur? ??-woy " • • January 25, 2007 ATTN: Bill Miller/ Mohn Funeral Home fox No• 39 8 - 6 9 63 This fax includes a map of the Clearwater Municipal Cemetery. Deceased: Ida Sweeney Gravesite: Block 16 / Lot 4 / Space 3 (B) Urn Space Urn Burial to take place: 02/03/07 Surrounding gravesites: Block 16 / Lot 4 / Space 1 Block 16 / Lot 4 / Space 2 Block 16 / Lot 4 / Space 3 Jonathon W. Adkins - Full Ernest C. Bush - Urn Edward E. Sweeney - Full Staking Fee: $30.00 Please make check payable to: City of Clearwater Mail to: City of Clearwater Official Records Dept. 112 S. Osceola Avenue Clearwater, FL 33756 Attn: Karen Vaughan Please contact me with any questions. Thank you, Karen Vaughan Official Records & Legislative Services City of Clearwater 727-562-4091 cc: JoEllyn King, Parks & Recreation Dept. 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N m rn I- "*rl Lewis W. Mahn Funeral Home 10-71 Phone 393-3481 9700 Seminole Boulevard Seminole, FL 33772 TO THE ! ORDER OF I 50900 63-751/631 BRANCH 13092 DATE 0- © c $? Feer, a= DOLLARS WACHOVIA Wachovia Bank, NA. ?/ wachovia.com FOR u'0509001i' i:0631075i31:2649SO2i52530,10 OFFICIAL RECORDS AND LEGISLATIVE SERVICES CITY OF C LEARWATE R POST OFFICE BOX 4748, CLEARWATER, FLORIDA 33758-4748 CITY HAIL, 112 SOUTH OSCEOLA AVENUE, CLEARWATER, FLORIDA 33756 TELEPHONE (727) 562-4090 FAX (727) 562-4086 .t February 2, 2007 Lewis W. Mohn Funeral Home Attn: Bill Miller 9700 Seminole Boulevard Seminole, FL 33772 Dear Mr. Miller: We are returning your check #50848 in the amount of $35.00 for the staking fee for the burial of Ida Sweeney. The actual amount due for a staking fee is $30.00. Please provide us with another check for the correct amount of $30.00. Thank you. Sincerely, ?d?kh LaCosse . Staff Assistant Official Records & Legislative Services Attachment RECEIVED OFFICIAL RECORDS AND I-ECISLATIVE SRVCS DEPT 131k 1?? L?? FRANK HIBBARD, MAYOR JOHN DORAN, COUNCILMEMBER HOYI' HAMILTON, COUNCILMEMBER BILL JONSON, COUNCIBIEMBF.R ® CARLEN A. PETERSEN, COUNCII.6IEMBER "EQUAL EMPLOYMENT AND AFFIRMATIVE ACTION EMPLOYER"