Scarborough, Vernon OCemetery Call Work Sheet
Date: 9- / « / Mct
Funeral Home / Monument Company: S Nt.I+11-- Jock, VGtheALAQ 1° fox,
Contact Name: R L L4 souk y Tel. #:/a-1- tH ?, -.a3 "?Fax #:
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)
Urn Space
Mary f. J C44.11. t ara Gl.
Full Burial
Owner of Plot:
Deceased Name: Ver 0 ,,
0 . S c of °'1.5.&,
Block $ Lot `( 3 Space 3
Date of Birth: O &/ O 3-/ I93 3 Date of Death a- / fi-- / a-oaa
Date of Burial: 4-/ 04 / 3-°316 Time: 11: 00 /pm (55°47 5po
$30.00 Staking Fee (Funeral Home) - received on: / ad / a -Oa° P.c,r w.-,4 At 14 -'75 -
Copy
`f''75 -
Copy of permit emailed to Mark Tokar, cc: Matt Anderson/P&R on: a / a 1 / aoao
***************************************************************It *********************** *le *********
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 11/15/17
LaCosse, Judith
From: LaCosse, Judith
Sent: Thursday, February 20, 2020 8:53 AM
To: Chaplinsky, Timothy; Brigman, Nathan
Cc: Anderson, Matthew; Vaughan, Karen
Subject: RE: Cemetery Staking Request
Thank you. I will notify the funeral home.
From: Chaplinsky, Timothy <Tim.Chaplinsky@MyClearwater.com>
Sent: Thursday, February 20, 2020 8:45 AM
To: Brigman, Nathan <Nathan.Brigman@MyClearwater.com>; LaCosse, Judith <Judith.LaCosse@myClearwater.com>
Cc: Anderson, Matthew <matthew.anderson@myclearwater.com>; Vaughan, Karen
<Karen.Vaughan@MyClearwater.com>
Subject: Re: Cemetery Staking Request
All flagged (pink)
Get Outlook for iOS
From: Brigman, Nathan <Nathan.Brigman@MyClearwater.com>
Sent: Wednesday, February 19, 2020 4:23:59 PM
To: LaCosse, Judith <Judith.LaCosse@myClearwater.com>; Chaplinsky, Timothy <Tim.Chaolinsky@MyClearwater.com>
Cc: Anderson, Matthew <matthew.anderson@myclearwater.com>; Vaughan, Karen
<Karen.VaughanftMyClearwater.com>
Subject: Re: Cemetery Staking Request
We will handle tomorrow and let you know flag marker colors.
Thank You,
Nathan Brigman
City of Clearwater Parks and Recreation Department
Landscape Manager
B.S. Ornamental Horticulture
ISA Certified Arborist
Office - (727) 562-4270 ext 7808
From: LaCosse, Judith <Judith.LaCosset myClearwater.com>
Sent: Wednesday, February 19, 2020 3:54:38 PM
To: Tokar, Mark <Mark.Tokar@myClearwater.com>
Cc: Anderson, Matthew <matthew.andersonPmyclearwater.com>; Brigman, Nathan
<Nathan.Brigman@MyClearwater.com>; Vaughan, Karen<Karen.Vaughan@MyClearwater.com>
Subject: Cemetery Staking Request
Good Afternoon,
We received a staking request from Robert Young from Smith -Young Funeral Home for a staking request for
an Urn burial for:
Deceased Name: Vernon 0. Scarborough in Block 8, Lot 95, Space 3
Other burials nearby in this plot:
Space 1= Russell C Vick - (full)
Space 2 = Lucy Watts - (full)
Space 4 = Mary F Scarborough - (full)
Staking is needed by this Friday, February 21'. Date of Burial is set for Monday, February 24th at around 11:00 a.m.
Please advise me of the color of the flags being used so that we could notify the funeral home.
Thank you.
Judith LaCosse
Staff Asst
City of Clearwater
ORLS Dept.
727-562-4093
2
PAY TO THE
ORDER OF
City of Clearwater
Thirty and 00/100'`***'********'
City of Clearwater
100 So. Myrtle Ave
Clearwater, FL 33756
Staking(Scarborough)
n■000 L 5 500" 1:06314014368 3.28 i064/ Vuis