Falzoni, James• Cemetery Call Work Sheet
Date: '
Funeral Home/ Monument Company: ' c-V10?
Contact Name: '?}-?-?? /?G- G(.cv(?Lev
Tel. #:-44-(,e"
Fax #:
Reason for call:
*-..eC-? eSC-k-a) -}-o
c.Q RR-1
?r) 5,P-e,-C--e -( Ftx? -+-
Deceased Name: ;
Date of Birth: / rte/ (pD- Date of Death
• Block 'S Lot 'DI- Space I
/gam
Owner of Plot:
Interment: (One full burial and one urn, or two urns per space)
Full Burial Urn Space
0.00 Staking Fee - received on: I2- / /
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) -A
41.?
•
December 11, 2006
ATTN: Dow Pettis / Rhodes Funeral Home
This fax includes a map of the Clearwater Municipal Cemetery.
Deceased: James Falzoni
Gravesite: Block 15 / Lot 92 / Space 3
Urn Space
Gravesite will be flagged by: call to advise please.
Urn Burial to take place: call to advise please.
Surrounding gravesites:
To the North: Block 15 / Lot 92 / Space 4 Louis Green
To the South: Block 15 / Lot 92 / Space 1 Carl Falzoni
• Staking Fee: $30.00
Please make check payable to: City of Clearwater
Mail to: City of Clearwater
Official Records Dept.
112 S. Osceola Avenue
Clearwater, FL 33756
Attn: Karen Vaughan
Please contact me with any questions.
Thank you,
Karen Vaughan
Official Records & Legislative Services
City of Clearwater
727-562-4091
cc: JoEllyn King, Parks & Recreation Dept.
City of Clearwater
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?. 00
INST # 95-183837
JLY 27, 1995 4:52PM
CEMETERY DEED
PINELLAS COUNTY FLA.
(I OFF.REC.BK 9061 PG 1143
THIS INDENTURE made this i' day of 1995, between
the City of Clearwater, Florida, a municipal co rati Grantor and VICTORIA
FALZONI, whose mailing address is 1487 GROV ST , CLEARWATER, FL 34615,
of the County of Pinellas, State of Florida, as Grantee:
WITNESSETH: That the said Grantor, for and in consideration of the sum of
$500.00, to it in hand paid by the said Grantee, the receipt whereof is hereby
acknowledged, has remised released and quit-claimed unto the said Grantee, and HER
S 0 heirs forever, all the right, title and interest, which the said Grantor has in and to the
dla following described parcel of land, lying and being in Pinellas County, State of Florida,
to wit: Space One (1), Lot Ninety-Two (92), Block Fifteen (15), Clearwater Cemetery,
as recorded in Plat Book 60, Page 30, Public Records of Pinellas County, Florida.
This conveyance is subject to the condition that Grantee herein shall not assign or convey said property without the written
consent of the Grantor, and to the further condition that said property shall be used only for cemetery purposes as human burial
sites and is subject to such other rules and regulations the City of Clearwater may adopt pertaining to use of said property.
TO HAVE AND TO HOLD the same to the only proper use, benefit, and behoof of the said Grantee and HER heirs and assigns
forever.
IN WITNESS WHEREOF, said Grantor has caused these presents to be executed in its name by its Mayor Commissioner, by its
City Manager, and to be attested and its corporate seal affixed by the City Clerk on the day and year first above written.
Cou gned: ITY OF CLEARWATER, FLORIDA
By.
Rita Garvey, Mayor-Comm' ioner Elizabeth Deptul jCity Ma er•,
Attest: /L9
Susan Stephenson, Deputy City Cler
STATE OF FLORIDA )
COUNTY OF PINELLAS)
Before me, the undersigned, personally appeared Rita Garvey, the Mayor-Commissioner of the City of Clearwater, Florida, to me
well known to be the person who executed the foregoing instrument and acknowledged the execution thereof to be her free act and
deed for the use and purposes herein set forth. ,
WITNESS my hand and official seal this 19day of 1995
(SEAL)
I P I'
Print/type name: o t ?G4S3o40
;D THRU
_
STATE OF FLORIDA 1 1 ?of fVV AfLAKnG oO.?DiNG Co., 1,4C.
COUNTY OF PINELLAS)
Before me, the undersigned, personally appeared Elizabeth M. Deptula, the City Manager of the City of Clearwater, Florida, to
me well known to be the person who executed the foregoing instrument and acknowledged the execution thereof to be her free act
and deed for the use and purposes herein set forth.
WITNESS my hand and official seal this
(SEAL)
Approv a t and I a utficiency:
Paul Richard Hull, Assistant City Attorney
day of 1995.
Notary Public
Print/type nam SPRY PU6 OFFICIAL N(_1T,kRV SEAL
2 47? !WREP!
i Ir} e r COMMISSR) Nilf SER
REY.,lr N TO- C025212g
LltTi ?? CL?{? ,:•'' COMMISSION EXP.
uFr
'4h, 2? 1997
E,0X 4743
Pp,Y P{J_ " .'OL`th! L. CRIN4?` otary ub is
C! F!J-'W,,ITFIR. F-1 '11,416-113.47 .418
f ° c`-r ? INST ## 95-183838
t_C'- ? JLY 27, 1995 4:52PM
SO CEMETERY DEED
?? -
THIS INDENTURE made this of of 1995, between
the -City of Clearwater, Florida, a municipal porap?il as Grantor and VICTORIA
FALZONI, whose mailing address is 1487 GR E STREET, CLEARWATER, FL 34615,
of the County of Pinellas, State of Florida, as Grantee:
WITNESSETH: That the said Grantor, for and in consideration of the sum of
$500.00, to it in hand paid by the said Grantee, the receipt whereof is hereby
acknowledged, has remised released and quit-claimed unto the said Grantee, and HER
heirs forever, all the right, title and interest, which the said Grantor has in and to the
following described parcel of land, lying and being in Pinellas County, State of Florida,
to wit: Space Two (2), Lot Ninety-Two (92), Block Fifteen (15), Clearwater Cemetery,
as recorded in Plat Book 60, Page 30, Public Records of Pinellas County, Florida.
COUNTY FLA.
9061 PG 1144
This conveyance is subject to the condition that Grantee herein shall not assign or convey said property without the written
consent of the Grantor, and to the further condition that said property shall be used only for cemetery purposes as human burial
sites and is subject to such other rules and regulations the City of Clearwater may adopt pertaining to use of said property.
TO HAVE AND TO HOLD the same to the only proper use, benefit, and behoof of the said Grantee and HER heirs and assigns
forever.
IN WITNESS WHEREOF, said Grantor has caused these presents to be executed in its name by its Mayor Commissioner, by its
City Manager, and to be attested and its corporate seal affixed by the City Clerk on the day and year first above written.
Cou s' ed: J"L WATER, FLORIDA
By:
Rita Garvey, Mayor-Commissioner Elizabeth Deptu City M ger
Attest: Aczr?
Susan Stephenson, Deputy City'Clerk
STATE OF FLORIDA ) ` t
COUNTY OF PINELLAS)
Before me, the undersigned, personally appeared Rita Garvey, the Mayor-Commissioner of the City of Clearwater, Florida, to me
well known to be the person who executed the foregoing instrument and acknowledged the execution thereof to be her free act and
deed for the use and purposes herein set forth.
WITNESS my hand and official seal this f8 day of 1995.
(SEAL)
- - - - ,,.&tarv Public
Print/type name: 463440
JjXPIRES MAY ,
BONaEO THRU
STATE OF FLORIDA ) j.. V 4E f? ATLANTIC BONDING CO., INC.
COUNTY OF PINELLAS) U
Before me, the undersigned, personally appeared Elizabeth M. Deptula, the City Manager of the City of Clearwater, Florida, to
me well known to be the person who executed the foregoing instrument and acknowledged the execution thereof to be her free act
and deed for the use and purposes herein set forth.
WITNESS my hand and official seal this /F1 day of J" I q_, 1995.
(SEAL)
Appro?ved? as to form and legal su ficiency:
I
Paul Richard Hull, Assistant City Attorney
CITY G1.FRI?
pog Orrlr` BOX 4740
Notary Public
Print/t petlA??n$fi OFFICIAL NOTARY SEAL
O ?,. KAREN ? * COMMISSION NUM 4ER
a Q CC2521Z9
MY COMMISVON EXP.
O F F FLOC JAN_?11:2,
PINELLAS
OFF.REC.BK
INST # 95-183836
-`" JLY 27, 1995 4:52PM
CEMETERY DEED
J fr /1 .
THIS INDENTURE made this day of , 1995, between
the City of Clearwater, Florida, a municipal cirSTRWr, tion s Grantor and VICTORIA
FALZONI, whose mailing address is 1487 GROV CLEARWATER, FL 34615,
of the County of Pinellas, State of Florida, as Grantee:
WITNESSETH: That the said Grantor, for and in consideration of the sum of
C $500.00, to it in hand paid by the said Grantee, the receipt whereof is hereby
acknowledged, has remised released and quit-claimed unto the said Grantee, and HER
f? heirs forever, all the right, title and interest, which the said Grantor has in and to the
following described parcel of land, lying and being in Pinellas County, State of Florida,
to wit: Space Three (3), Lot Ninety-Two (92), Block Fifteen (15), Clearwater Cemetery,
as recorded in Plat Book 60, Page 30, Public Records of Pinellas County, Florida.
This conveyance is subject to the condition that Grantee herein shall not assign or convey said property without the written
consent of the Grantor, and to the further condition that said property shall be used only for cemetery purposes as human burial
sites and is subject to such other rules and regulations the City of Clearwater may adopt pertaining to use of said property.
TO HAVE AND TO HOLD the same to the only proper use, benefit, and behoof of the said Grantee and HER heirs and assigns
forever.
IN WITNESS WHEREOF, said Grantor has caused these presents to be executed in its name by its Mayor Commissioner, by its
City Manager, and to be attested and its corporate seal affixed by the City Clerk on the day and year first above written-.
Coun a 'gned: CITY OF CLEARWATER, FLORIDA
By:
Rita Garvey, Mayor-Commis ner Elizabeth Deptula, Ma ger
Attest:
Susan Stephenson, Deputy City Clerk
STATE OF FLORIDA )
COUNTY OF PINELLAS)
Before me, the undersigned, personally appeared Rita Garvey, the Mayor-Commissioner of the City of Clearwater, Florida, to me
well known to be the person who executed the foregoing instrument and acknowledged the execution thereof to be her free act and
deed for the use and purposes herein set forth, I r
WITNESS my hand and official seal this 0 'wday of 1995.
ISO
(SEAL) Notary Public
,Rp1kY pie CAE1L1 Y11! L. f3ii)I•!K
Print/type name: ° +" WCM%4!5810N It Ce 463040
EXPIRES .,:Y 22,1999
BONDED THRU
STATE OF FLORIDA } 8F fvw ArLAmT!c sowaln:s co., INC.
COUNTY OF PINELLAS)
Before me, the undersigned, personally appeared Elizabeth M. Deptula, the City Manager of the City of Clearwater, Florida, to
me well known to be the person who executed the foregoing instrument and acknowledged the execution thereof to be her free act
and deed for the use and purposes herein set forth.
WITNESS my hand and official seal this day of L( 1995.
(SEAL)
Appro ed a form a=al ency: Print/
Paul Richard Hull, Assistant City Attorney RE I U`'N O.
UPI Y CLERK
poS o,!: 1,r'E BOV
PINELLAS COUNTY FLA.
OFF.REC.BK 9061 PG 1142
I 3rn hA Ufg
Notary Public
o,?P'Ry p&
eOFFICIAL NOTARY SEAL
T KAREN DOM13ROWSKI
k COMMISSION NUMBER
CC252129
MY COMMISSION EXP.
'10F FLn
1'
C I T Y OF C L E A R W A T E R
POST OFFICE BOX 4748
CLEARWATER, FLORIDA 34 6 1 8-4 74 8
Department of the
City Clerk
(813) 462-6684
4
August 10, 1995
Mrs. Carl F. Falzoni
1487 Grove Street
Clearwater, FL 34615
Dear Mrs. Fa-1zon i;
Enclosed are the deeds which indicate that you own the following
described parcels of land, lying and being in Pinellas County,
State of Florida, to wit: Spaces 1, 2, & 3, Lot 92, Block 15,
Clearwater Cemetery.
These deeds have been recorded in Official Records Book 9061 on
Pages 1142, 1143, and 1144.
It is important to keep these deeds in a safe place and to make a
note of the official record book and page numbers. In the event
the original deeds are lost or destroyed, this information will
be needed to obtain copies from the Pinellas County Clerk of the
Circuit Court.
If we may be of service in the future, please call upon us.
Yours very truly,
Susan Stephenson,
Documents & Records Supervisor
SS: cm
Encl.
-Equal Employment and Affirmative Action Employer"