Henderson, Eveleyn CrowleyCemetery Call Work Sheet
Date: lb / /
Funeral Home / Monument Company: ('toss feAiCA.
Contact Name: ''v Tel. #:-7.)-1-51, 3-- ao 1 o Fax #:
Reason for call: Staking Request (Interment/Disinterment)
Affidavit (Burial Rights)
Monument (Marker) being placed (No fee for staking of monument)
For: �d.�Q�,1 C. HenJl.XJLSaw (Cr-o�..,Qe )
Block .7 Lot -7J. Space a. 6A-siiP)
Date: / / Time:
(Send email to P&R)
Verifying Burial space
Other reason:
******************************************************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
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 emailed to Mark Tokar, cc: Cherise Sarnoff /P &R 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
Revised 11/24/14
LaCosse, Judith
From: LaCosse, Judith
Sent: Tuesday, October 06, 2015 9:05 AM
To: Tokar, Mark
Cc: Wells, Alexis; Sarnoff, Cherise; Vaughan, Karen
Subject: RE: Cemetery Staking - Placement of a marker
Thanks... I will notify the funeral home.
Judith LaCosse
Staff Asst
City of Clearwater
ORLS Dept.
727 - 562 -4093
From: Tokar, Mark
Sent: Tuesday, October 06, 2015 8:39 AM
To: LaCosse, Judith
Cc: Wells, Alexis; Sarnoff, Cherise; Vaughan, Karen
Subject: RE: Cemetery Staking - Placement of a marker
Yellow flags.
From: LaCosse, Judith
Sent: Monday, October 05, 2015 3:45 PM
To: Tokar, Mark
Cc: Wells, Alexis; Sarnoff, Cherise; Vaughan, Karen
Subject: Cemetery Staking - Placement of a marker
Importance: High
We received a staking request this afternoon from Karen at Moss Feaster for placement of a marker.
The location is Block 7, Lot 72, Space 2 for Evelyn C. Henderson
The staking is needed ASAP and the time is open (depending on the weather).
Other Burials nearby in Block 7, Lot 72:
Space 1— vacant
Space 2 — Evelyn C Henderson — full burial
Space 3 — Evelyn Crowley — full burial
Please let me know the color of the flags you will be using so that I could notify Karen at Moss Feaster.
Thank You.
Judith LaCosse
Staff Asst
City of Clearwater
ORLS Dept.
727 -562 -4093
J,'J)'~JJ..('..':'--....
I' . ~L' -,
.') (, \." ,''''/''':'_..
~t.:....\ ~..... (..//.,.-
,1--':::: /~ / ,-~
'\:-"'(.i ~.~'"
.'t....i ,',:"")- ~ ~
~ -, / ' '-., ~ ,'.1 ' "
~...., -,.........'~.. <1"
~.-- \ .; I:::l \
t~.--,.~,\
~ "VA" .-- .. / {'-..~. \'
"=-"r:;'-<..=-::.;..--;;~, 11
~--1'A TE\t~li'
.~"'''''',I'~JJ'
C I T Y
OF
CLEARWATER
POST OFFICE BOX 4748
CLEARWATER. FLORIDA 34618-4748
Department of the
City Clerk
(813) 462-6684
May 18, 1995
Ms. Melody L. Long
Bonner, Hogan & Coleman, P.A.
P. O. Box 1640
Clearwater, FL 34617
RE: ESTATE FOR EVELYN CROWLEY, deceased
Dear Melody:
This letter is to inform you of the status of the cemetery property which was conveyed to
EVELYN CROWLEY by Dr. R. F. Wyatt, and his wife, Edna F. Wyatt on Feburary 18, 1952.,
as per your phone request this morning.
The cemetery property is described as Lot Seventy-two (72), a four (4) space lot, and the
North one-half of Lot Eighty-three (83), which consist of two (2) spaces, Block Seven (7) in
the Clearwater Cemetery.
Our records indicate burials and burial rights (via handwritten notes in our lot book) in/to the
spaces as follows;
Block 7, Lot 72, Space 1
Block 7, Lot 72, Space 2
Block 7, Lot 72, Space 3
Block 7, Lot 72, Space 4
Block 7, N 1/2 83, Space 3
Block 7, N 1/2 83, Space 4
Block 7, N 1/2 83, Space 4
Reserve for Eveleyn Crowley Henderson 1
Reserve for Eveleyn Crowley Henderson
Interment - Evelyn Crowley
Interment - Charlotte Ann Rawlry
Reserve for Dr. Charles Crowley
Interment (Urn) - Margaret Bour Crowley
Interment (Urn) - Charles Raymond Crowley
Call me if more information is needed.
Sincerely,
;/ (L
/(() C:L-, 'v" 'cJt L.
Camille Motley, CRM
Central Records Specialist
em
@
"Equal Employment and Affirmative Action Employer-