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Coachman, Winifred Jl i Cemetery Call Work Sheet Date: Funeral Home: N'ibS- JO) "r Contact Name: C [L. 4 Jkal ??- Tel. #: U u ?9 IS'I S Fax #: `I - Zcl Monument Company: Contact Name: Tel. #: Fax #: ki? 4- M S4" L/ -Z-Cq) -- hank C 7 6q b 1d1 Deceased Name: ?? DOD: DOB: `+ Owner of Property: ?Ui S ??C??hwu? Block -4--- Lot I Space Interment: ? Full Burial: ? Urn Space: ($30.00 Staking Fee) - (One full burial and one urn, or two urns) Date of Burial: Disinterment: Time: am/pm The following authorization should be obtained prior to disinterment: 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) S:/Jlacosse/Cemetery Call Work Sheet.doc 6/8/04 SEE ?I AVENUE 94 81 1 80 65 64 49 1 93 82 79 66 63 50 29 1 28 1 23 1 22 1 13 12 1 7 1 6 30 ?G O PL ^ r ?b 19 14 3 18 15 2 17 16 9 I 16 15 6 I 5 0.?y) O 17 14 7 4 11 8 3 9 2 10 I 12 119 13 18 :PROSPECT AVENUE 1 SHEET 25 15 15 6 5I l 24 17 14 E7 4 18 17 23 18 13 B 3 19 16 22 i 1Fl, 9 2 20 IS 21 20 10 I 21 14 19 18 6 K 22 13 20 17 ? 5 J 2? 12 1=1 q II r 22 15 W 10 3 H 25 10 E23- 14 II 2 G 26 9 24 13 12 I F 27 8 16 IS ? 5 E 28 7 17 14 ? 4 D 29 6 18 13 ? 3 C 30 5 19 12 ? .. 2 B 31 4 20 21 14;5::: 0 1 A 32 28 ;933 3 2 22 23 26 27 30 34 1 rrC VI D D V J T? N rn MYRTLE