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Shea, Jan• Cemetery Call Work Sheet • Date: _1124- / a� y: Contact Name: Tel. #: Fax #: 4 t5 •C`—� Reason -for call: - Email: -3\/S�-tC xx Staking Request - Interment $30.00 staking fee (Weekdays) - $50.00 staking fee (Saturday, Sunday & Legal Holiday) Full Burial Urn Burial (One full burial and one urn, or two urns per space) Owner of Plot: Deceased Name: i23 -t\04. -n i n r' 5,-, ,� ,yva Mcg✓ • Block 3 Lot I,Space k.O � t I Date of Birth: / / Date of Death / / Date of Burial: / / Time: am/pm • "" Monument (Marker) being placed - (No fee for staking of monument) • For: Block Lot Space Date: / / Time: Affidavit (Burial Rights) Verifying Burial space Other reason: ********* *xx ,e ******** *: xx**x x*** *****;*************************** ***,�*********** * Send email to P&R to stake the space ''' /4/23 Y � vL�S '� �� Notify funeral home/monument company with color of the flags used to mark the space Staking fee received on: / / From: Copy of permit emailed to: Nathan Brigman, cc: Matt Anderson, Tim Chaplinsky, Erick Peterson 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 ORLS/Cemetery/FormsPermitsTemplates/Cemetery Call Work Sheet -20 Revised 44/21/2021 • • Vaughan, Karen From: Vaughan, Karen Sent: Friday, November 3, 2023 11:29 AM To: jvshea2@gmail.com Subject: Clearwater Municipal Cemetery Attachments: Block 3 Lot 13.pdf Hello Jan! Attached is a map of the cemetery. I've marked where your folks are (Block 3 / Lot 13 / Spaces 10 & 11). The shed is on the opposite side of the cemetery. You will enter the cemetery from Cleveland Avenue. Turn left (South) onto Myrtle from Cleveland. There isn't a huge sign for the cemetery. You will notice the headstones as you are traveling along Myrtle. You'll cross over Tuskawilla Street and then turn in one of the little driveways into the cemetery on your left. There are poles with Block/Lot numbers on them but not space numbers. I asked Parks & Rec to flag them but they require a few days notice so I wouldn't expect them to be flagged unfortunately. Hope this helps! Thanks! Karen B. Vaughan Administrative Assistant City of Clearwater Official Records & Legislative Services Ph: 727-562-4091 Fax: 727-562-4086 1 14 15 16 17 16 7 6 5 4 3 19120 2 1 570 571 572 573 574 575 576^ 563 562 561 560 559 558 557 553 554 555 556 540 539 538 537 530 531 532 533 534 535 536 523 522 521 520 519 518 517 510 503 511 502 512 501 SHEET 3 513 500 two 1*( ec o. 1 ..- •- 1 -- 107 86 83 62 59 38 35 14 11 J{85 84 61 60 37 36 13 (177 176 155 154 133 132 111 178 175 156 153 134 131 112 109 90 179 174 157 152 135 130 113 108 91 182 171 158 114 92 11061 11811 172 159 1150151 1137 1281115 93 182 171 160 149 138 127 116 105 94 183 170 161 148 139 126 117 104 95 118 4 169 16214 7 188 168 1631146 1410124 119 102 12 5 118 103 96 97 (08 67 66145 44 23122111 87 114 11 1111 186{183 84 162 61 159 6 0 3 7135 36 13 24 (08 67 66145 44 23122111 87 68 65 46 43 24 21 2 86 69 64 47 42 25 20 3 85 70 63 48 41 26 19 4 84 71 62 49 40 27 18 5 81 74 59 52 37 30 15 8 182 73 60 51 } 38 29 16 7 81 74 59 52 37 30 15 8 80 75 58 53 36 31 14 9 ['79 76 57, 54135 132 94 61 80 65 64 49 93, 62 79 66 63 50 92 83 78 17 62 51 91 84 77 68 61 I 0 85 76 61 60 48 33 32 17 47 34 31 I0 46 35 30 511 13 10 56 55 134 133 14 3 52 4 45 N S3 44 89 86 75 70 54 54 • IMICIIalm® ,® 72 CIO 36 21 201 13 4 37 28 21 12 5 43 36 27 22 11 6 42 39 26 23 10 7 41 40 25 24 9 6 4 3 35 Pa 27 36 31 28 37 30 29 <51 \Sol „ 24 1 21 \1\ � 1 • 26 25 20 8 5 10 4 19 10 14 15 24 ,17 14 23 18 0 13 . 1 6 6. ori 22 19 12 21 20 11 9 2 10 19 JI 7 6 6 20 11 8 5 3 12 11 ,, 19 ,,.19 ,16'. 20 15 21 14 22 13 �3 12 1I-1 1 21 I 16 1 1 9 11 4 I I I 24 1 I 22 15 e .0 \\17 16 9 1 16 15 17 I 14 18 13 11 12 6 5 19 12 20 21 9 22 23 26 3 2 0 F 23 10 26 9 27 8 5 id 25 I 7 4 0 29 6 3 C 2 5 A 25 29 27 30 30 5 31 4 32 3 33 2 34 C cn rn