Zigenfuss, KathyCemetery CaII Work Sheet
ate: 5 129 ao)
Contact Name: LC -a-
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Contact # or Email:
Reason for call:
A: ** STAKING REQUEST for .terment
$30.00 staking f- eekdays) - $50.00 staking fee (Saturday, Sunday & Legal Holiday)
ulI Burial
Urn Burial
(One full burial and one urn, or two urns per space)
Owner of Plot:
Deceased Name:
Verify Ownership/Burial Rights in cemetery program before confirming:
Block Lot Space
Date of Birth: / / Date of Death / /
Date of Burial:
******************************************************************************************************
B: ** STAKING RE for Monument to be placed
No fee for ng of monument
•
ased Name:
Block
Lot
Space
Verify Ownership/Burial Rights in cemetery program before confirming:
C: ** OTHER REASON: n
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*****************************************************************************************************************************
Sent email to P&R to flag the space / /
Notified funeral home/monument company with color of the flags used to mark the space
Staking fee received (if applicable): / / From:
Copy of burial permit emailed to:
Nathan Brigman, cc: Matt Anderson, Tim Chaplinsky in 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
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City Clerk/Cemetery/FormsPermitsTemplates/Cemetery Call Work Sheet -20
Revised 12/27/2023