Moravec, JosephCemetery Call Work Sheet
Date: -7 / 7 / %o l I
Funeral Home/ Monument Company: Garlt kj 5c.#.ctk!ng_
Contact Name: bebr*.
Tel. #: `7a--7- III- O L I Fax #:
Reason for call: Staking Request (interment/Disinterment)
Affidavit (Burial Rights) )
? Monument (Marker) being placed (No fee for staking of monument)
F. V- Fri WWU.114
Verifying Burial space Dzce-w.QA , `e:0°
( Ntarr IJic?o(s (IA4rr aeA
Other reason: 1 3
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Interment: (One full burial and one um, or two urns per space)
Full Burial Urn Space R4 1?ccJS
at-ok -7) ??t I ?t 1 S p. 3
Owner of Plot:
Deceased Name:
Block Lot Space
Date of Birth: Date of Death
Date of Burial: Time: am/pm
$30.00 Staking Fee (Funeral Home) - received on:
Copy of permit faxed to Joe Taylor/P&R - Fax No. 6551 on:
Disinterment:
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
Revised 6/29/11
LaCosse, Judith
From: Taylor, Joe
Sent: Friday, July 08, 2011 9:33 AM
To: LaCosse, Judith
Subject: RE: Three Staking Requests - Monuments being placed
Yes, that is correct
From: LaCosse, Judith
Sent: Friday, July 08, 20119:31 AM
To: Taylor, Joe
Subject: FW: Three Staking Requests - Monuments being placed
Importance: High
Never mind Joe,
I did notice that you numbered them. So, I'm assuming that it goes in the same order as I had them in the email. 1 =
Nichols, etc.
Judith
From: LaCosse, Judith
Sent: Friday, July 08, 20119:29 AM
To: Taylor, Joe
Subject: RE: Three Staking Requests - Monuments being placed
Importance: High
Joe,
Can you tell me which color goes with what name. They will probably ask me.
Thanks,
Judith
From: Taylor, Joe
Sent: Friday, July 08, 20119:25 AM
To: LaCosse, Judith
Cc: Tokar, Mark; Wells, Alexis; Gilmore, Stephanie; Vaughan, Karen
Subject: RE: Three Staking Requests - Monuments being placed
I used different Colo s for all three
1.Green -'N0`0?S
2. Red - Rorl ve-c- ?l +1 S?4 eo????nse K ?r?c ve??
$ tJ
3. Yellow _ New
36
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- 4
From: LaCosse, Judith
Sent: Thursday, July 07, 2011 12:48 PM
To: Taylor, Joe
Cc: Tokar, Mark; Wells, Alexis; Gilmore, Stephanie; Vaughan, Karen
Subject: Three Staking Requests - Monuments being placed
Importance: High
Hi Joe,
We received a call this morning from Debra at Garden Sanctuary requesting the following 3 spaces to be staked for
placement of monuments:
1. Block 7, Lot 87, Space 3 - Deceased, Mary E. Nichols (Mary Beth) - Full
Other burials nearby: Space 1= Archer Nichols - Full
Space 2 = Elizabeth Nichols - Full
Block 2, Lot 7, Space 3 - Deceased, Joseph Moravec - Urn
Other burials nearby: Space 1= Samuel Coachman, Jr. & Anne Coachman - Infants
Space 2 = Samuel Coachman - Full
Space 4 = Evelyn Coachman - Urn & Solomon Coachman - Full
3. Block 7, Lot 141, Space 3 - Deceased, Ruth M. Dews - Full
Other burials nearby: Space 1= John Cheatham - Full
Space 2 = Peachie Cheatham - Full
They would like the staking to be completed by tomorrow, July 8th late afternoon at around 4:00 p.m. If possible they
would like to have the monuments placed before the weekend.
Please advise me on the color of the flags being used on these three spaces so that I could notify them.
Thanks for your help.
Judith LaCosse
Staff Asst.
Official Records & Lebislative Services
727-562-4093
Cemetery Call Work Sheet
•
Date: 2-0+/ IO
Funeral Home/ Monument Company: Moss ?C?C'lSt?l(L
Contact Name: Va"_Q
Tel. #: % ° ao w Fax #: a - 3073
Reason for call: S0a(A
chew 2 wi- Q to
cJ
Deceased Name:
Date of Birth: /-rQ / 169,q Date of Death 0
Block A Lot Pl Space 3
• j
Owner of Plot: &AeittA dcap.hrxa-k-? 1,k) I P(,
a16 ?noh l:o aC_ A.cLh+
Interment: (One full burial and one urn, or two urns per space)
Full Burial Urn Space T-e
$30.00 Staking Fee - received on: a-° ° c 17?1
Date of Burial: Time: a:oo am/ mp,?! I )icy
Disinterment:
? I r'o:3 o a.M .
The following authorization should be obtained prior to disinterment: f?? ??:? (?L?C'C?°
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)
L -I
Crystal Reports Viewer Page 1 of 1
P t§ 1 / 1 Main Report [ 100 0
Status of Block: 2 Lot: 7 as of 10/29/2010
INTERMENTS:
SPACE BURIALTYPE DECL DECF DECM BIRTH DEATH INTERRED
I INFANT COACHMAN, JR SAMUEL C 10/2/1934 12/14/1937
1 INFANT COACHMAN ANNE 7/20/1909 06 / 09 / 1910
2 FULL COACHMAN SAMUEL C 12/6/1904 07 / 14 / 1946 7/14/1946
4 URN COACHMAN EVELYN M 6/25/1912 05 / 09 / 1997 5/14/1997
4 FULL COACHMAN SOLOMON S 4/4/1862 03 / 09 / 1931
5 FULL COACHMAN JESSIE C 9/19/1877 07 / 09 / 1959 7/13/1959
5 URN COACHMAN SR HUGH M 1/6/1907 08 / 03 / 1984 8/14/1984
6 FULL COACHMAN JAMES W 3/14/1911 10/19/1994 10/22/1994
7 FULL COACHMAN WINIFRED 4/16/1911 07 / 27 / 2004 8/2/2004
9 INFANT COACHMAN, JR S S 8/19/1902 04 / 30 / 1913
9 FULL COACHMAN JODIE 5/13/1889 10 / 30 / 1905
10 FULL COACHMAN, JR HUGH M 12/22/1863 11/17/1902
10 INFANT COACHMAN INFANT GIRL 10/9/1892 10 / 09 / 1892
12 FULL COACHMAN BUDDY 8/6/1920 01 / 21 / 2000 1/26/2000
13 FULL COACHMAN MARGARET P 4/16/1921 08 / 23 / 1980 8/26/1980
14 FULL COACHMAN LILLIAN H 1/12/1916 09 / 24 / 1968 9/27/1968
DISINTERMENTS FROM SPACE:
No Matching Records
REINTERMENTS:
No Matching Records
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LaCosse, Judith
From: Taylor, Joe
Sent: Monday, November 01, 2010 1:33 PM
To: LaCosse, Judith
Cc: Tokar, Mark; Wells, Alexis; Sprague, Nicole; Gilmore, Stephanie; Vaughan, Karen
Subject: RE: Cemetery Staking
Yellow flags
From: LaCosse, Judith
Sent: Friday, October 29, 2010 12:45 PM
To: Taylor, Joe
Cc: Tokar, Mark; Wells, Alexis; Sprague, Nicole; Gilmore, Stephanie; Vaughan, Karen
Subject: Cemetery Staking
Importance: High
Hi Joe,
We received a call this morning from Paul at Moss Feaster requesting a staking for an Urn burial for:
Joseph Moravec, who passed away today, October 29th. He's to be buried in Space 3 of Block 2. Lot 7.
Owner of plot - Solomon Coachman
Other burials nearby in this Blk 2, Lot 7:
Space 1= Samuel Coachman, Jr. & Anne Coachman - Infants
Space 2 = Samuel Coachman - Full burial
Space 4 = Evelyn Coachman - Urn burial
Space 4 = Solomon Coachman - Full burial
Date of Burial: Week of November 1st, staking needed by middle of next week.
Please advise as soon as you can the color of the flags used to stake this area. We will then, notify Paul at Moss
Feaster.
Thanks for your help.
Judith LaCosse
Stuff Asst.
+D.ficial Records R Legislative Services
727-562-4093
November 1 st, 2010
Attn: Paul
Funeral Home: Moss Feaster
Fax: 727-562-2073
(This fax includes a copy of Cemetery Map)
# in the circle is the Block, # in the square is the Lot
Deceased: Joseph Moravec
Gravesite: Block 2, Lot 7, Space 3
Urn Space
Gravesite flagged with Yellow flags.
Nearby Burials:
Space 1 = Samuel Coachman, Jr. & Anne Coachman - Infants
Space 2 = Samuel Coachman - Full burial
Space 4 = Evelyn Coachman - Urn burial
Space 4 = Solomon Coachman - Full burial
Staking Fee: 30.00
Please make check payable to: City of Clearwater
Mail to: City of Clearwater
Official Records Dept. - 2"d Floor
112 S. Osceola Ave.
Clearwater, FL 33756
Please contact me with any questions.
Thank you,
Judith LaCosse
Staff Assistant
Official Records & Legislative Services
City of Clearwater
727-562-4093
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PROSPECT AVENUE
CITY OF CLEARWATER
POST OFFICE Box 4748, CLEARWATER, FLORIDA 33758-4748
CITY HALL, 112 SOUTH OSCEOLA AVENUE,, CITARVW11R, FLORIDA 33756
TF.1,17PHONE (727) 562-4090 FAx (727) 562-4086
OFFICIAL REcORDs AND
LE(ISI.ATIVE SERVICES
November 17, 2010
Moss Feaster Funeral Home
693 South Belcher Road
Clearwater, FL 33764
To Whom It May Concern:
We received your Cemetery Staking Fee check #10079253 in the amount of $30.00
for the interment of Joseph Moravec.
Attached you will find receipt No. 442660.
Thank you,
dith LaCosse
°goN° 442660
CITY OF CLEARWATER, FLORIDA
¢• MISCELLANEOUS RECEIPT Date
.ghRF '° 20 i
y
Received from
??fi^?t
In payment of-e+i? vuc- ?-
1 UfJ _..
Amount received
Dollars
Fund Code
CITY OF CLEARWATER
1-)epartment -'bt (_j
Rece>ved By
I
Vendor No. Vendor 11/12/2010
3141616 CITY OF CLEARWATER 10079253
PAYMENT DETAILS
Staking fee -Moravec #01001292
Moss Feaster Funeral Home and Crema
Amegy Bank N.A.
693 South Belcher Road ss-iizs 10079253
Clearwater, FL 33764 Porter, TX 30
11/12/2010
PAY Thirty and 00/100 Dollars
rj?-
L -A h'
PAY TO THE
ORDER OF
CITY OF CLEARWATER
112 S OSCEOLA AVE
CLEARWATER, FL 33756
***********$30.00
Memo ' Staking fee -Moravec #01001292
111 100 7 9 2 5 311' i:LL3LL058D: 4,41,0707211•
BURIAL PERMIT
CLEARWATER CARETAKER
CLEARWATER, FL
Permission is hereby granted for burial of:
Name of Deceased: JOSEPH MORAVEC
Owner of Property: SOLOMON S COACHMAN &
Block : 2 Lot: 7 Space: 3
Date of Death: October 29, 2010
Funeral Home Director: PAUL - MOSS FEASTER
Time: 10:30 Staking Fee: 30.00
PERMIT # 2618
November 18, 2010
Burial Type: URN
Date of Birth: August 22, 1927
Date of Burial: November 21, 2010
Date Paid: November 17, 2010
Clearwater Cemetery
?° ?4-
By