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Cassell, Frances v'A (N Cemetery Call Work Sheet ? Date: Funeral Home: Monument Company: Contact Name: Contact Name: Tel. #• LA -\LQ_" Tel. #• Fax #: ?O Fax #: RE: ?--- ?; 1:1? j? / ?lL?-l Deceased Name: F(C.(1( `_? CGS`?P DOD: ?S DOB: Owner of Propertj?r Block Lot Sp a a a- Interment: Full Burial: Urn Space: ($30.00 Staking Fee) (One fuulllburial and one urn, or two urns) -( Date of Burial: Ncj? a Time: anVe Disinterment: xx /l.e 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) [Q? l / ?y( Vaughan, Karen From: Vaughan, Karen Sent: Friday, November 18, 2005 10:08 AM To: Gracie, Rhonda; King, JoEllyn; Lewis, Eric Subject: Staking Request Hi! We've had a request for a staking for an urn burial that will take place Monday, Nov. 21 st in the afternoon. Please acknowledge you've received this request and can mark the space in time. Deceased is Frances Cassell. Space is: Block 8 Lot 87 Space 1 or 3 (There is a marker already there with Frances and George Cassell's names on it.) Spaces nearby: Block 8 Lot 87 Space 2 (to the ? side) George Cassell (husband) Block 8 Lot 88 Space 2 (to the West) William H. Tarvin Thanks! Karen Vaughan Sr. Staff Assistant Official Records and Legislative Services Phone: 727-562-4091 karen.vaughan@myclearwater.com 1 1 30 1 29 128 127 ' ?!? 1 24 1 23 1 22 121 1 .L 177 176 1SS 1S4 133 132 III 110 89 178 17S 156 153 134 13I 112 109 90 179 174 157 IS2 135 130 113 108 91 I80 173 158 151 136 129 114 107 92 181 172 159 150 137 128 115 106 93 88 6T 66 43 r44 23 22 1 87 68 6S 46 43 24 21 2 86 69 64 47 42 1 25, 120 3 70 63 48 41 216 r84 TI 62 49 40 27 IS S IOS 94 'J 182 171 160 149 138 127 1161, 183 170 161 148 139 126 117 104 9S 83 72 61 50 39 28 I7 6 82 73 60 SI 38 29 11 7 164 169 162 147 140 12S 118 103 96 186 166 163 ___J[461141 124 119 102 97 AV E NUF_ 42 39 26 23 10 7 41 40 25 24 9 8 76 1 57 • 54 135 32 7-9 56 55 ;54,133 34 33 26 2S 16 ?14,. e 6. 1J11d,1.11111 % 33 j12 2727 24, , 17 14 7 ?4 I° ;,17 LJ?.J t 36 31 28... 23 Ie ?.., Fq, [37 30 29 22 I9 12 9 2 20 IS 21 20 11 10 1 21 14 13 12 7 6 1° ?° D ° , K 22 . 13 29 28 23 22 to n D s ? xs 12 30 24 21 4 1 L 1 24 26 23 20 4 1? /may, { 10 22 IS 9.01 3 M 2S 10 IS 2 23 14 11 2 G 26 9 r1111v 7,v6y 14 3 ?DDD 16 9 I 24 13 12 I I.F 27 ?i. 8 - 16 15 6 5 16 ! 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Eden Prairie, MN 60522000 03 Moss Feaster Funeral Home(4676) 01 802 North Fort Harrison Avenue Gelco Check Number 111621 l- 66 1 V? ?.. Clearwater FL 33755 1-1 ID Issue DATE gunterkm 2/1/2006 PAY TO THE NOT VALID AFTER SIX (6) MONTHS FROM ISSUE DATE ORDER OF City of Clearwater 8 „ ma s?=z--, p 112 South Osceola Avenue °etals°"ba`k Offical Records/Karen Vaughan Clearwater FL 33756 Sixty Dollars And No Cents*+********************************************* $ * * * 6 0.0 0 NOT VALID F 'OVER $5.000 NOT REDEEMABLE FOR CASH BY DRAWER'S AUTHORIZED REPRESENTATIVE -???'=--af?A..r-?- SIGNATURE OF DRAWERS AUTHORIZED REPRESENTATIVE PAYABLE THROUGH 78-858 William C. Stewart First PREMIER Bank 914 By signing this instmment, the aforesiggned confirms that this instrument has been drawn in accordance with the authority issued by Geloo Information Network, Inc. If any SIOUX FALLS, SD statement herein be untrue, we, the a, oresigned, agree to pay the drawer upon demand the amount of this instrument and all expenses and damages arising from such misstatement u'0 L L L 6 2 L 4 L LO' 1:09 L4013 58 Si: 2 5000006 5 5 SIGNER William C. Stewacrt gunterkm 01 116 21411 DESCRIPTION City of Clearwater 112 South Osceola Avenue Offical Records/Karen Vaughan Clearwater FL 33756 DATE LOCATION NUMBER GL CODES CONTRACT NUMBER NAME/DESCRIPTION AMOUNT 2/1/2006 4676 8405-0 Bjerkenes Staking Fee $********30.00 2/1/2006 4676 8405-0 Cassell Staking Fee $********30.00 t, L.F ISLATIVE SRVCS D' F Vaughan, Karen From: King, JoEllyn Sent: Friday, November 18, 2005 1:32 PM To: Vaughan, Karen Subject: RE: Staking Request Space 3, blue flags -----Original Message----- From: Vaughan, Karen Sent: Friday, November 18, 2005 11:07 AM To: King, JoEllyn Subject: RE: Staking Request Great! Thanks! Karen Vaughan Sr. Staff Assistant Official Records and Legislative Services Phone: 727-562-4091 karen.vaughan@myclearwater.com -----Original Message----- From: King, JoEllyn Sent: Friday, November 18, 2005 11:05 AM To: Vaughan, Karen Subject: RE: Staking Request received your request, will handle today and notify you when finished. Joe Taylor PSTIII Downtown Team -----Original Message----- From: Vaughan, Karen Sent: Friday, November 18, 2005 10:08 AM To: Gracie, Rhonda; King, JoEllyn; Lewis, Eric Subject: Staking Request Hi! We've had a request for a staking for an urn burial that will take place Monday, Nov. 21 st in the afternoon. Please acknowledge you've received this request and can mark the space in time. Deceased is Frances Cassell. Space is: Block 8 Lot 87 Space 1 or 3 (There is a marker already there with Frances and George Cassell's names on it.) Spaces nearby: Block 8 Lot 87 Space 2 (to the ? side) George Cassell (husband) Block 8 Lot 88 Space 2 (to the West) William H. Tarvin Thanks! Karen Vaughan Sr. Staff Assistant 1