Winston, Valerie Cemetery Call Work Sheet
Date: 3 / a9 / la`
Funeral Home / Monument Company: C.7 fr v-- 11..e(t Co .
Contact Name: kzvi hire
Tel. #: "78&- 155 I Fax #:
Reason for call: Staking Request (Interment/Disinterment)
/Affidavit (Burial Rights)
V Monument (Marker) being placed (No fee for staking of monument)
r : VA-CeA-Z.e 10; ( )
Verifying Burial space Ikool I 14) Ldt (8l, Sp• S:efic
Other reason: (-re.T a r auvj ►^tip k e-i.
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Interment: (One full burial and one urn, or two urns per space)
Full Burial Urn Space
Owner of Plot:
Deceased Name:
Block Lot Space
Date of Birth: / / Date of Death
Date of Burial: / / Time: am/pm
$30.00 Staking Fee (Funeral Home) - received on: / /
Copy of permit faxed to Joe Taylor/P&R - Fax No. 6551 on: / /
**************************************************************************************************
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
3/30/a - N if; ti.c Mr. C, ,1 fr ,t€
Revised 6/29/11 .6/1414 (r,kK) (-144 fo 4.n,e..4.
CJ" '
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LaCosse, Judith
From: LaCosse, Judith
Sent: Thursday, March 29, 2012 11:50 AM
To: Ortega, Marco
Cc: Tokar, Mark; Wells, Alexis
Subject: Cemetery Staking Request
Importance: High
Tracking: Recipient Read
Ortega,Marco
Tokar,Mark
Wells,Alexis Read:3/29/2012 12:15 PM
Hi Marco,
We just received a call from Kevin Cantrell of Cycadia Monument Co. requesting a staking for placement of a monument
for:
Deceased person in Block 14, Lot 181,Space 00—Valerie Winston (was interred 11/12/11)
Staking is needed by next Wednesday.April 4th.
Please advise as soon as you can the color of the flags being used so that we could notify the monument company.
Thanks for your help.
Judith LaCosse
Staff Assistant
Official Records and
Legislative Services Dept.
727-562-4093
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LaCosse, Judith
From: Ortega, Marco
Sent: Friday, March 30, 2012 2:37 PM
To: LaCosse, Judith
Cc: Tokar, Mark; Wells, Alexis
Subject: RE: Cemetery Staking Request
Marked in pink flags..
From: LaCosse, Judith
Sent:Thursday, March 29, 2012 11:50 AM
To: Ortega, Marco
Cc: Tokar, Mark; Wells, Alexis
Subject: Cemetery Staking Request
Importance: High
Hi Marco,
We just received a call from Kevin Cantrell of Cycadia Monument Co. requesting a staking for placement of a monument
for:
Deceased person in Block 14. Lot 181.Space 00—Valerie Winston (was interred 11/12/11)
Staking is needed by next Wednesday,April 4`h
Please advise as soon as you can the color of the flags being used so that we could notify the monument company.
Thanks for your help.
Judith LaCosse
Staff Assistant
Official Records and
Legislative Services Dept.
7227-562-4093
1