Brown, John MichaelC]
Cemetery Call Work Sheet
Date: ? / l8 / a`:21
Funeral Home > Monument Company:
Contact Name: ° n y f- 0 to
Tel. #: `7a-7 - 651- I`ta3 Fax #: -7a?-
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Reason for call
Deceased Name:
Date of Birth: Date of Death
• Block J`f Lot ( 1 Space d 0
Owner of Plot:
Interment: (One full burial and one urn, or two urns per space)
Full Burial
Urn Space
$30.00 Staking Fee - received on:
Date of Burial: Time: am/pm
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
Monument Being Placed: (No Fee for Staking of Monument)
0
LaCosse, Judith
From: LaCosse, Judith
Sent: Friday, June 18, 2010 2:40 PM
To: 'iluvmealwayseb@yahoo.com'
Subject: Clearwater Municipal Cemetery burial - John M Brown, Jr.
Importance: High
Hi Ebony,
John M Brown, Jr. was buried in Block 14, Lot 61, Space 00 at the Clearwater Municipal Cemetery. The owner of this
plot per our cemetery program is Willard Jones.
See attached information and copies of the cemetery map. The number in the circle is the Block (14), then see sheet 3
for the Lot (61) between 60 and 62 at the bottom right. (Not all the lot numbers appear)
If you have any other questions, please give me a call.
Have a nice weekend !!
FT I
LJ
Brown Jr., john
m. pdf
.Iudith LaCosse
Stuff,-Asst.
Official Records & Legislative Services
727-562-4(193
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Cemetery Address
1300 S Myrtle Ave
Clearwater FL 33756
Map