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Lopez, Manuel • Cemetery Call Work Sheet Date: Funeral Home/ Monument Company: Ahh?ll(-f)n,?? o l,?,Q1'}l(,l?'!_ Contact Name: ?1Sl?l Tel. #: 51q - Fax #: T « -1550 Reason for call: Wt ?.pDS Lug LOP?? Deceased Name: Ua n ua Date of Birth:/ 5 / l 5 Date of Death • Block 15 Lot Space ? ??? ?o-' ko 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: I / I`f / a° Io 0 scr-V a9 I 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) *vw na CEMETERY BURIAL INFORMATION BY BLOCK/LOT/SPACE • BLOCK : 15 LOT: 18 DECEASED NAME: ALBERT TAYLOR BLOCK: 15 LOT: 18 SPACE: 1 BURIALTYPE: FULL BORN: 01 / 01 / 1889 DIED: 06 / 23 / 1976 INTERRED: 06 / 23 / 1976 INTERMENT NOTES: DECEASED NAME: BEATRIZ TAYLOR BLOCK: 15 LOT: 18 SPACE: 2 BURIALTYPE: FULL BORN: 02 / 18 / 1910 DIED: 05 / 12 / 1997 INTERRED: 05 / 14 / 1997 INTERMENT NOTES: DECEASED NAME: LURA LOPEZ BLOCK: 15 LOT: 18 SPACE: 3 BURIALTYPE: URN BORN: 07 / 20 / 1921 DIED: 11 / 10 / 2005 INTERRED: 01 / 30 / 2006 INTERMENT NOTES: STAKING FEE REC'D 03/04/2006 FROM R. LEE WILLIAMS & SON FUNERAL HOME, INC. ****END OF BLOCK : 15 LOT: 18 **** • n L---A Page 18 of 120 ELI 32 3! 34 - 37 3e 39 142 30 29 2e 27 24 23. 22 x( I11 112 IIS 114 IIS 111611171110 119 120 - I10 109 106 IO7 106 IOS 104 10!.102 101 91 92 f3'. 94 95 96 97 98 99 100 [90109 e8 187184105 81 83 82- el 71 72 73.74 - 77 is 79 80 70 69 e? 67 64 63 62 61 31 52 53 34 SS 36 S7 SD S9 60 50 49 4e 47 46 45 44 4! 42 41 .567 566 369 570 571 572 573 574 575 576 566 563 364 563 562 561 360 559 558 SS7 •. 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N rr1 m r- VTT/ cD C r r D VI FTJ 1 _ F MYRTt_F ;',' Avt NUE _ ' LL Clearwater TO: City of Clearwater, Florida Official Records & Legislative Services Department Phone (727) 562-4090 Fax (727) 562-4086 FAX MESSAGE Don LOCATION: Abbey Affordable Cremation FAX NO.: 517-1580 COMMENTS: Cemetery Staking for Lopez 0 FROM: Nicole Sprague (727-562-4097) DATE: 3/9/2009 NUMBER OF PAGES THIS MESSAGE (INCLUDING THIS PAGE): 2 Don, Following please find the map of the cemetery with the location of the burial site for Mr. Manuel Lopez. Yellow flags were used to stake the plot. Please send the $30.00 staking fee to the following address: City of Clearwater Official Records & Legislative Services Attn: Nicole Sprague PO Box 4748 Clearwater, FL 33758 Thank you. E CITY OF CLEARWATER, FLORIDA MISCELLANEOUS RECEIPT Received from ALLY A,; m,1,L4 Lrer-Jim'-- Na 441449 Date J?? u Tt `t 20 I SDnlli lvAJ 1` In payment of Vi h? 7 .t-t - Mcttik 4 Lope 0W Amount received -- 7k-1 rt`1- a "•? ? Dollars Fund f G Code `t CITY OF CLEARWATER 30,(-10 C'LJ- N 4Lt UOs Department - Up_ L- ABBEY AFFORDABLE CREMATION & FUNERAL SERVICES INC 12541 ULMERTON ROAD 727-517-2340 LARGO, FL 33774 24005 63-751/631 BRANCH 03807 DATE Q C) - o? so?, WAlCHOVIA Wachovia Bank, N.A. (J ?, - ?q ,? a n wachovia.com FOR J ?A)L)a !? M JON u 112021.0050 1:06 3 LO 7 5 L 31: 209000 2Sg 3 7 6 Iii' a--k+L Receive toy BURIAL PERMIT CLEARWATER CARETAKER CLEARWATER, FL Permission is hereby granted for burial of: Name of Deceased: MANUEL LOPEZ PERMIT # 2604 January 14, 2010 Burial Type: URN Owner of Property: MANUEL LOPEZ & LAURA E LOPEZ Block : 15 Lot: 18 Space: 4 Date of Birth: December 5, 1915 Date of Death: January 13, 2009 Date of Burial: March 10, 2009 Funeral Home Director: DON - ABBEY AFFORDABLE CREMATION Time: : Staking Fee: 30.00 Date Paid: January 14, 2010 Clearwater Cemetery By