Cochran, EvelynL'
Date: 6 / -7 / awo
Cemetery Call Work Sheet
Funeral Home / Monument Company:
Contact Name: RI Q 'F'
Tel. #: E" a _ a-b7v
Reason for call:
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Fax #: 56 a - 30 3
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Deceased Name: (Gv ?a ?hr a ?-.
Date of Birth: 9 / a-O / l ct I -? Date of Death °6 / fl 3 / a o ( o
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Block 7 Lot 5V Space 3
Owner of Plot: ?b? ru ?? Jae f} . Coc Ev
Interment: (One full burial and one urn, or two urns per space)
Full Burial Urn Space
$30.00 Staking Fee - received on: / aal aD 1o
sue.
Date of Burial: G Time: /'D °O m m
*********************************************************************** **********************
Disinterment:
The following authorization should be obtained prior to disinterment: 14
1.) A disinterment permit and burial/cremation transit permit v?C T-yYj&, w
2.) Written authorization from the individual(s) who currently own the burial rights 6 fa????
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)
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.Crystal Reports Viewer
Page 1 of 1
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Status of Block: 7 Lot: 58 as of 06/07/2010
INTERMENTS:
SPACE BURIALTYPE
1 FULL
2 FULL
4 FULL
DISINTERMENTS FROM SPACE:
No Matching Records
REINTERMENTS:
No Matching Records
DECL DECF DECM BIRTH DEATH I:
COX JESSIE A 1/1/1892 01/18/1971 1.
COX CLEVELAND T 1/1/1900 01/01/1940 1.
COCHRAN DONALD D 2/14/1918 03 / 04 / 2008 3.
Page 1 of I
14 f k 1/1
http://msb-crystal-ent/businessobj ects/enterprise 11 /infoview/viewers/rpt/DHTMLV fewer. as... 6/7/2010
June 10, 2010
Attn: Rick Chesler
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: Evelyn Cochran
Gravesite: Block 7, Lot 58, Space 3
Full Space
Gravesite flagged with Red flags.
Nearby Burials:
Space 1 = Jessie Cox - Full
Space 2 = Cleveland Cox - Full
Space 4 = Donald Cochran, Jr. - Full
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
FYI: Marker in Block 1, Lot 3, Space 14 reads:
Don "Dad" Cochran, Sr. 1892-1987.
We will make correction in our system
Please contact me with any questions.
Thank you,
Judith LaCosse
Official Records & Legislative Services
City of Clearwater
727-562-4093
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Clearwater
City of Clearwater, Florida
Official Records and
Legislative Services Department
Phone (727) 562-4090
Fax (727) 562-4086
FAX MESSAGE
TO: Rick Chesler
LOCATION: Moss Feaster
FAX NO.: 727-562-2073
COMMENTS: Rick,
See attached list for burials in Block 1, Lot 3.
There's a Donald Cochran, Jr. is buried in Space
14. Maybe this list will help.
FROM: Judith LaCosse, (727-562-4093)
DATE: 6/7/2010
NUMBER OF PAGES THIS MESSAGE (INCLUDING THIS PAGE): 2
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Moss Feaster Funeral Home (4673) Gelco Check Number 13460383
O1 34603838
693 South Belcher Road
Clearwater FL 34624 USER ID ISSUE DAZE
wellsjh 6/10/2010
PAY TO THE NOTVALID AFTER SIX (6) MONTHS FROM ISSUE DATE
ORDER OF City of Clearwater
k.
112 s Osceloa Avenue 8 Details on b ,I - ba,ck,
Clearwater FL 33756
Thirty Dollars And No Cents************************************************ $***30.00
NOT VALID' FOR OVER $5,000 NOT REDEEMABLE FOR CASH BY DRAWER'S AUTHORIZED REPRESENTATIVE
SIGNATURE OF DRAWERS AUTHORIZED REPRESENTATIVE
PAYABLE THROUGH Paul MacLaren
First PREMIER Bank 78 858
SIOUX FALLS, SD 914 By signing this instrument, the e (gresi confirms that this instrument has been drawn h accordance with the authority issued by Gelco Information Network, Inc. If any
statement herein be he untrue, we, , the a foesigned, agree to pay the drawer upon demand the amount unt of of this instrument and all expenses and damages arising from m such misstatement.
u'0 1 34r.0 38 3glie x:09 1408 58 D: 2 500000 6 S S119
SIGNER Paul MacLarerLSERID wellsjh
01 34603838
DESCRIPTION
City of Clearwater
112 s. Osceloa Avenue
Clearwater FL 33756
DATE LOCATION NUMBER GL CODES CONTRACT NUMBER NAME / DESCRIPTION AMOUNT
6/10/201 4673 8405-0 467301001208 Cochran - Staking fee $********30.00