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Willoughby, Robert4 Date: ?/ / -7 10't Funeral Home: Monument Company: Contact Name: °beri _Q ` YouU Contact Name: Tel. #: $ 5 q- a y S` -70 5 7 Tel. #: Fax #: Cemetery Call Work Sheet Fax #: O e kh rrw- +?4 M.c7rl,u ryll? ,A) a k4 +o L v t zfa? C"._ 9fvl.- U e_ A-le-Ij 6-1v Ck " C.-Y &-)-? -LJ ? A%? , Deceased Name: DOD: Owner of Property: Rd L e r-t ` Block ra Lot ? Space Interment: Full Burial: ($30.00 Staking Fee) - (One full burial and one urn, or two urns) Date of Burial: Disinterment: S 9 DOB: -7 _ l 1- S LA M ? Urn Space: 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) 5 5 rt. J P o,? - 4 4, -a37S ?'1v . 'i Qo u.? ?, W 1LJ1 c ju r?,. ?t 61, k& l/ e 0. ACW- O,ti-2 p i S:/Jlacosse/Cemetery Call Work Sheet.doc 6/8/04 LaCosse, Judith From: LaCosse, Judith Sent: Thursday, June 17, 2004 1:43 PM To: King, JoEllyn Cc: Norman, Lois Subject: Resetting of a Stone Hi JoEllyn, Can you answer this question for me? I received a call today from Mr. Robert Willoughby who has a son buried in the Clearwater Cemetery. He wants to have the stone on the grave reset due to it being somewhat tilted and moved. He lives in KY but he had someone from his family go to the cemetery to check the gravesite and this is what he was told. Is it required to have a staking done in this case by Parks & Rec to have the stone reset by a monument company? Or can Parks & Rec be able to do the resetting of the stone withouth having the area staked? Mr. Willoughby wanted to know what he needs to do. Please Advise, Thanks, Judith x4093 ORLS ?? 70 £QQ??..of;.c Sic k C??Qd1 ?'-J ?o 41r-OL,a Lfe'- -1-kt ?toti.A w? . a- Crv uY tAS 1 C 'W Mr.?i oK???c? aj asvit4 Ikti,. o? 4L- z , Ht e-?A i? Cv! W CB. v ,,/I %/C V I nn? 0 n n J U. C&&x I 4w . 1