Sowell, CarolynCemetery Call Work Sheet
Date: q / oC o/ c2nl
Funeral Home / Monument Company: GGt T a br Pu ler-- Home
Contact Name: LC-1 Tel. #: 1 514.5 ` ax #:
Reason for call: V Staking Request (Interment/Disinterment)
Affidavit (Burial Rights)
_ 1,tt up s
— v R
Monument (Marker) being placed (No fee for staking of monument)
For:
Block 12- Lot Oil Space
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: kt I� Crijk3
Deceased Name: @'O91 S Did
Block iZ Lot " i 1 Space 2
Date of Birth: ID / � / I "t43 Date of Death q / 11/ Lvt o
Date of Burial: °I / LZ / 2.0[ (to. Time: ZOO am/
$30.00 Staking Fee (Funeral Home) — received on: 'i / a3 / / b
Copy of permit emailed to Mark Tokar, cc: Cherise Sarnoff /P &R on:
9-e.
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PQA (`f S�
cLcic 1-cisa3
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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
1
Status of Block: 12 Lot: 97 as of 09/20/2016
INTERMENTS:
SPACE BURIALTYPE DECL DECF DECM BIRTH DEATH INTERRED PERMIT
1 FULL SPEARS JOHN L 1/1/1900 06 / 28 / 1966 6/28/1966 516
3 FULL CRIBBS HATTIE M 4/7/1908 10 / 22 / 1990 10/24/1990 1914
4 FULL CRIBBS, JR LUTHER J 10/15/1928 12 / 10 / 1993 12/14/1993 2129
DISINTERMENTS FROM SPACE:
No Matching Records
REINTERMENTS:
No Matching Records
Page 1 of 1
LaCosse, Judith
From: Gilmore, Stephanie
Sent: Tuesday, September 20, 2016 2:40 PM
To: LaCosse, Judith
Subject: FW: Cemetery Staking - Full Burial
Can you please call Mr. Taylor and let him know that blue flags were used to stake the plot?
Thank you.
From: Tokar, Mark
Sent: Tuesday, September 20, 2016 1:41 PM
To: Gilmore, Stephanie
Subject: RE: Cemetery Staking - Full Burial
Blue flags.
From: Gilmore, Stephanie
Sent: Tuesday, September 20, 2016 9:32 AM
To: Tokar, Mark
Cc: Wells, Alexis; Sarnoff, Cherise; Vaughan, Karen; LaCosse, Judith
Subject: Cemetery Staking - Full Burial
We received a call from Ed from Edward Taylor Funeral Home. tel. #727 - 545 -9858, requesting a staking for full burial in
the following space:
Carolyn Sowell in Space 2 of Block 12, Lot 97 DOB: 10/11/1943 — DOD: 9/17/2016
Other burials nearby in this plot:
Space 1: John Spears (full)
Space 3: Hattie Cribbs (full)
Space 4: Luther Cribbs, Jr. (full)
Staking is needed by September 22, 2016 at 2:00 pm.
Please advise me with the color of the flags being used so that we could notify Ed of Edward Taylor Funeral Home.
Thank You.
Stephanie Gilmore
City Clerk Specialist
City of Clearwater
(727)562 -4227
Stephanie .Gilmore(c�myclearwater.com
1
TAYLOR FONERALH
727548 -9858
5300 PARK SJr1/D
PINELLAS PARK, FL 3378.1:''
PAY TO THE
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FIRST HDME BANK
SEMINOLE, FLORIDA 3377.W:
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