Turner, Joseph K Jr.Date:
/$
Funeral Home /
/ 15
Monument Company:
Contact Name: Jev vi
Reason for call:
Cemetery Call Work Sheet
Cyc 1 tvnkw. ek� Lo .
Tel. #: /55- 1 Fax #: -1 5-- 08 56
Staking Request (Interment/Disinterment)
Affidavit (Burial Rights)
✓Monument (Marker) being placed
(No fee for staking of monument)
4...4,k. u T 1,
For: k. -it—A ,.7
Block 4 Lot l Space
Date: 1° / 31 / da15 Time:
(Send email to P &R)
Verifying Burial space
Other reason:
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K)0-111,t(2-et C7c4d tA01,144.11�0.3-it .
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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 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: Tokar, Mark
Sent: Thursday, October 29, 2015 9 :07 AM
To: LaCosse, Judith
Cc: Wells, Alexis; Sarnoff, Cherise; Vaughan, Karen
Subject: RE: Cemetery Staking Request for Monument Placement
Yellow flags were used for all.
From: LaCosse, Judith
Sent: Wednesday, October 28, 2015 3:51 PM
To: Tokar, Mark
Cc: Wells, Alexis; Sarnoff, Cherise; Vaughan, Karen
Subject: Cemetery Staking Request for Monument Placement
Importance: High
We received a call today from Kevin of Cycadia Monument Co. tel. #727 - 786 -1551, requesting stakings for monument
placements in the following spaces:
spaces 41, 42 & 43 and 44 of Block 4, Lot 1
Staking is needed by Saturday, October 31st.
Other burials nearby in this plot:
Space 39 = Joseph K Turner Sr — (full)
Space 40 = Laura W Turner — (full)
Please advise me of the color of the flags being used so that we could notify Kevin of Cycadia Monument Co.
Thank You.
Judith LaCosse
Staff Asst
City of Clearwater
ORLS Dept.
727 - 562 -4093
•
October 29, 2015
Attn: Kevin Cantrell / Cycadia Monument Co.
Fax: 727 - 785 -0856
Block 4, Lot 1
Joseph K. Turner, Jr. - Space 41
Joan W. Turner - Space 42
Robert F. Turner - Space 43
James E. Turner - Space 44
Gravesites flagged with Yellow flags
Nearby Burials:
Space 39 = Joseph K. Turner Sr. — (full)
Space 40 = Laura W. Turner — (full)
If you have any questions please give me a call at 727 - 562 -4093.
Thank you,
dith LaCosse
fficial Records & Legislative Services
City of Clearwater