Perkins, Frasier Cemetery Call Work Sheet
Date: ° / a S / 1
Funeral Home / Monument Company: 5vw� A�be�
Contact Name: CL -c- 131-o
Tel. #: la"] - 796 _ Iq'7 a-- Fax #: 721 7 ° 43 1
Reason for call: Staking Request (Interment/Disinterment)
Affidavit (Burial Rights)
Monument (Marker) being placed (No fee for staking of monument)
Verifying Burial space
Other reason:
**************************************************************************************************
Interment: (One full burial and one urn, or two urns per space)
Full Burial Urn Space ✓
Owner of Plot: rrc_sie-r P:en�4�S
Deceased Name: Fr«,.f y.Y' -ei V./.113
3=
Block !L. Lot 10 Space 4 (3 ) - L . Pw,k-z -(
Date of Birth: / a / 19,)-`1' Date of Death b / a 1 / I a
Date of Burial: 7 / 10 I adl - Time: ;0:0 a/pm it xj 904'0✓
$30.00 Staking Fee (Funeral Home) — received on: 7 /- / I� ��""" " "I���f
Copy of permit emailed to Mark Tokar, Marco Ortega/P&R on: 7 / ' / I t
**************************************************************************************************
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
Revised 5/31/12
LaCosse, Judith
From: Ortega, Marco
Sent: Tuesday, July 03, 2012 2:41 PM
To: LaCosse, Judith
Cc: Tokar, Mark; Wells, Alexis; Gilmore, Stephanie
Subject: RE: Staking Request for Urn burial
Yellow flags at the foot.
Regards,
Marco
From: LaCosse, Judith
Sent: Monday, July 02, 2012 12:32 PM
To: Ortega, Marco
Cc: Tokar, Mark; Wells, Alexis; Gilmore, Stephanie
Subject: Staking Request for Urn burial
Importance: High
Hi Marco,
We received a call this morning from Charles Brown from Sylvan Abbey requesting a staking for an Urn burial for:
Frasier Perkins in Block 16, Lot 10,Space 4—DOB—7/2/1924- DOD 6/21/2012
** (See attached status sheet regarding burials in this block and lot) **
Family would like Mr. Frasier Perkins to be buried with wife,Martha L. Perkins who's buried in Space 4(Full burial).
Staking is needed by Tuesday.July 10th at 10:00 a.m. (Time may change)
Please advise me with the color of the flags being used so that we could notify the funeral home.
Thanks for your help.
Judith LaCosse
Staff Assistant
Official Records and
Legislative Services Dept.
727-562-4093
1
Status of Block: 16 Lot: 10 as of 07/02/2012
INTERMENTS:
SPACE BURIALTYPE DECL DECF DECM BIRTH DEATH INTERRED PERMIT
1 FULL SMITH GEORGIA L 2/22/1907 09/08/1996 9/14/1996 2275
2 FULL HAMMOND,JR JOHNNIE 9/26/1950 08/28/1996 9/4/1996 2273
4 FULL PERKINS MARTHA L 9/1/1923 04/05/1993 4/9/1993 2093
DISINTERMENTS FROM SPACE:
No Matching Records
REINTERMENTS:
No Matching Records
Page 1 of 1
July 3, 2012
Attn: Charles Brown
Funeral Home: Sylvan Abbey
Fax: 727-799-4361
(This fax includes a copy of Cemetery Map)
#in the circle is the Block,#in the square is the Lot
Deceased: Frasier Perkins
Gravesite: Block 16, Lot 10, Space 4
Urn Space
Gravesite flagged with Yellow flags (at the foot).
Date of burial: 7/10/2012 at 10:00 a.m.
Nearby Burials:
Space 1 = Georgia L Smith (full burial)
Space 2 = Johnnie Hammond, Jr. (full burial)
Space 4 = Martha L Perkins (full burial)
Staking Fee: $30.00
Please make check payable to: City of Clearwater
Mail to: City of Clearwater
Official Records Dept. — 2nd Floor
112 S. Osceola Ave.
Clearwater, FL 33756
Please contact me with any questions.
Thank you,
Judith LaCosse
Official Records & Legislative Services
City of Clearwater
727-562-4093
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