Turner, Willie Jean (2)Cemetery CaII Work Sheet
Date: / / (46'
Funeral Home / Monument Company: vu h A .)45e_y 1T H.
Contact Name: A04 Ka. Tel. #: "�d7- �4b._/) ?9d- Fax #: 3
Reason for call: Staking Request (Interment/Disinterment)
Affidavit (Burial Rights)
Monument (Marker) being placed (No fee for staking of monument)
For:
Block Lot Space
Date: / / Time:
(Send email to P &R)
Verifying Burial space
Other reason:
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Interment: (One full burial and one urn, or two urns per space)
Full Burial Urn Space ✓
Owner of Plot: .�sr Harr 5
Deceased Name: Qe 7e��� 1 c�.n,e� (S l-,e
Block lit Lot 315- Space 00
Date of Birth: 67 / `I / 11.37 Date of Death LI- / 5 / Dt io
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Date of Burial: $ / l6 / aal b Time: am /pm i\i ° "`''
$30.00 Staking Fee (Funeral Home) - received on: ` /) / ) L (C-A,
Copy of permit emailed to Mark Tokar, cc: Cherise Sarnoff /P &R on: 5- / i9 / doe, 4,,,,,
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**************************************************************************************************
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
JDS
7
Status of Block: 14 Lot: 315 as of 05/04/2016
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INTERMENTS:
SPACE BURIALTYPE DECL
DECF DECM BIRTH DEATH INTERRED PERMIT
00 FULL HARRIS JOSEPHINE 5/16/1921 08 / 16 / 1999 8/21/1999 2502
00 URN TURNER WILLIE JEAN 0
DISINTERMENTS FROM SPACE:
No Matching Records
REINTERMENTS:
No Matching Records
Page 1 of 1
LaCosse, Judith
From:
Sent:
To:
Cc:
Subject:
Orange flags.
Tokar, Mark
Friday, May 06, 2016 9:33 AM
LaCosse, Judith
Wells, Alexis; Sarnoff, Cherise; Vaughan, Karen
RE: Cemetery Staking Request - Urn Burial
From: LaCosse, Judith
Sent: Wednesday, May 04, 2016 10:36 AM
To: Tokar, Mark
Cc: Wells, Alexis; Sarnoff, Cherise; Vaughan, Karen
Subject: Cemetery Staking Request - Urn Burial
Importance: High
I received a call this morning from Alana from Sylvan Abbey F.H. requesting a staking for an Urn burial for:
Willie Jean Turner in Block 14, Lot 315, Space 00
DOB: 6/29/1937 — DOD: 4/15/2016
(There's a full burial already on this space — Josephine Harris, owner of this plot and mother of deceased)
Staking is needed by next Friday, May 13th for an (urn) burial before noon.
Please advise me with the color of the flags being used so that we could notify the funeral home as soon as possible.
Thanks for your help.
Judith LaCosse
Staff Asst
City of Clearwater
ORLS Dept.
727 - 562 -4093
1
May 6, 2016
Attn: Alana
Funeral Home: Sylvan Abbey F.H.
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: Willie Jean Turner
Gravesite: Block 14, Lot 315, Space 00
Urn Space
Gravesite flagged with Orange flags
Date of burial: 5/13/2016 by 11:00 a.m.
Note: Josephine Harris, owner of this plot is buried in this space — full burial
(The maximum capacity of a space is two burials provided at least one person is
cremated)
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