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Darling, LeaCemetery Call Work Sheet fate: 4 /t../ Lao, -Tx (ti Contact Name.: Lea f l; a-1 scio‘ts. —PtlflrH rn tMonumenni eoiTTTpe y: Contact # or Email: J t Z� 6 Co,?.-‘ Reason for call: A: ** STAKING REQUEST for Interment $30.00 staking fee (Weekdays) - $50.00 staking fee (Saturday, Sunday & Legal Holiday) Full Burial Urn Burial t ` S (One full burial and one urn, or two urns per space) S Deceased Name: Verify Ownership/Burial Rights in cemetery program before confirming: �‘ Block Lot Space Date of Birth: / / Date of Death / / Date of Burial: / / Owner of Plot: B: ** STAKING REQUEST for Monument to be placed No fee for staking of monument Deceased Name: • Block Lot Space Verify Ownership/Burial Rights in cemetery program before confirming: C: ** OTHER REASON: Cer- Lk)C- /b1CDCSI.C. LC4 S3FC%-C—e " C- v ; c . i I4.O(c Pr ‘' Cc 1 tC 1(1 - r -t ed)� 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 5h -else 0-1 Kay (1 L . Fr i e)d)G /4/(.0 CYtwNc-{'iSs-'e''° c.t- Fook a( ,-ts- City Clerk/Cemetery/FormsPermitsTemplates/Cemetery Call Work Sheet -20 Revised 12/27/2023 z(4'1015\J • Vaughan, Karen • • From: Vaughan, Karen Sent: Tuesday, April 23, 2024 4:21 PM To: leadarling27@icloud.com Subject: Cemetery question / Friedt Hi! See below info we found for the Friedt family in the Clearwater Municipal Cemetery: Thanks! Karen B. Vaughan Administrative Assistant City of Clearwater City Clerk Department Ph: 727-444-7150 Fax: 727-562-4086 KORA L. FRIEDT Block 5, Lot 24, Space 10 HOMER H. FRIEDT Block 5, Lot 24, Space 9 https://citvofclearwater.maps.arcgis.com/apps/webappviewer/index.html?id=5326fb45e6e64115821f187543f90a 1b 1 5-23-3 SNYDER 5-23-2 SNYDER 5- 23-1 SWDER 5-23-11 SCOTT 5-23-10 SCOTT 5-23-9 SCOTT 5-24-6 MCKISSON 5-24-14 DUFFEY 5-24-5 MCKISSON 5-24-13 DUFFEY 5- 24-4 M CKISSON 5-24-12 SUMLIN 5-24-3 MCKISSON 5-24-11 5-24-2 MCKISSON 5-24-1 MCKISSON HOMER FRIEDT, Plot Number: 5-24-9 Lag NamRIEDT F -s: Name HOMER M,cdle t H D03 11/1/ 886 DOD 5-249 8,113:" 958 8,17.1' 958 arector Fern) z Nur aer 1343 S le Note EkNbe 5 Lot N Jrnber 24 Hot N,rnbe• 9 Len 33 Zoom to • •