Koontz, Ruth T
Cemetery Call Work Sheet
Date: / P- 11 / 0-7
Funeral Home/ Monument Company: N?°F.id?•. Sou??y C?w'u
Contact Name: I-A Ky," X3°g
Tel. #: -7 a--) - 5 36, - o `F R
Fax #:
Reason for call: E -te"K ,,.2 &S
Next ..Sati. N- kooK f-2?
Deceased Name: t
Date of Birth: 03 Date of Death 06 / aa-
Block S Lot S Space Q--
Owner of Plot: G/ehn ?ooKfi? - OKs ?? - Sp I
**************************************************************************************************
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: 0"7 / 0(o / 07 Time: 0:00 am b-
**************************************************************************** ******************
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
pt" Arce
of Monument)
Tw? (ar f'A,,k5& I've c
c;?,?,?
LaCosse, Judith
From: LaCosse, Judith
Sent: Tuesday, July 03, 2007 2:30 PM
o: Taylor, Joe
*c: Lewis, Eric; Frith, Renee; Sprague, Nicole; Gilmore, Stephanie
Subject: Staking for Urn Burial!
Importance: High
Hi Joe,
We received a call from Jeff Myers from National Cremation Society of Clearwater.
Please stake Block 15, Lot 5, Space 2 for an URN burial. The deceased person's name is Ruth T. Koontz and she's the
wife of the owner, Glenn Koontz.
The burial is scheduled for Friday, July 6th at 12:00 pm. Date of death was 06/22/07 and date of birth was 03/14/22.
Other burials in Block 15, Lot 5:
Space 1 - Glenn Koontz - Urn
Space 3 - Oliver Snodgrass - Full
Space 4 - Draxie Snodgrass - Full
Let us know what colors flags you will be using so that we could advise Mr. Jeff Myers.
Thanks for your help.
Onlith LaCosse
Staff Assistant
Official Records & Legislative Services
Citij of Clearwater
Phone: 727-562-4093
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