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Smith, Carol & Smith Richmond GDate: 1 / a / a°I' Funeral Home / Contact Name: Reason for call: Monument Company: Cemetery Call Work Sheet 111 rvv or 1 J RAlc Ce n, e -er . G- (4" Tel. #: - S;/ - `t"h Fax #: Staking Request (Interment/Disinterment) Affidavit (Burial Rights) Monument (Marker) being placed (No fee for staking of monument) c S�„tif l� l i �� �► «1d 6. 5h_i_ _ . 1f6g. For: Block 1 `f Lot 4-6d-Space Date: I 1 / `l / lc.. Time: &- / 3 /i ce (Send email to P &R) Verifying Burial space Other reason: Io:oo ej,Yr- • Interment: (One full burial and one urn, or two urns per space) Full Burial Owner of Plot: Deceased Name: Urn Space Block Lot Space Date of Birth: / / Date of Death / / Date of Burial: / / Time: am /pm vu.)1 .1?,9527 ucz1-9? ©J '(`A \(0 $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 Vaughan, Karen From: Tokar, Mark Sent: Tuesday, November 29, 2016 1:38 PM To: Vaughan, Karen Subject: RE: Cemetery Staking - Placement of a marker Green flags for Carol (the ones that were already there) and Orange flags for Richard ( the only color I had). From: Vaughan, Karen Sent: Tuesday, November 29, 2016 11:54 AM To: Tokar, Mark Subject: FW: Cemetery Staking - Placement of a marker Importance: High Hi Mark! Judith is out on vacation for a week. Please let me know color of flags. Thanks! Karen B. Vaughan Administrative Analyst City of Clearwater Official Records & Legislative Services Ph: 727 - 562 -4091 Fax: 727 - 562 -4086 From: LaCosse, Judith Sent: Monday, November 28, 2016 12:38 PM To: Tokar, Mark Cc: Wells, Alexis; Sarnoff, Cherise; Vaughan, Karen; Gilmore, Stephanie Subject: Cemetery Staking - Placement of a marker Importance: High We received a staking request this morning from Jon Garland from Memorial Park Cemetery for placement of a double marker. The location is Block 14, Lot 461, Space 00 & Block 14, Lot 462, Space 00 for Richmond G. Smith & Carol A. Smith. The staking is needed by tomorrow, November 29th or Wednesday, November 30th and around 10:00 a.m. Surrounding burials: Block 14, Lot 463, Space 00 = Buddy Williams (Infant) Note: P &R had already marked this location with green flags on November 4th for Moss Feaster. Not sure if the flags are still there so please stake this location again. Please let me know the color of the flags you will be using so that we could notify Jon from Memorial Park Cemetery. Thank You. 1