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Cycadia• • • Cemetery Call Work Sheet Date: 5. / y4:95 Funeral Home / Monument Company: Contact Name: V -12"I leTh Tel. #: Fax #: lri•Fcs 'n -,C.1 '\e - e "r loYi o�V1�t +-�[ti, +. C � Email: Reason for call: ** 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: Block Lot Space 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 40 Space Affidavit (Burial Rights) Other reason: Date: 5 / Time: Verifying Burial space ********************************************************************************************* Send email to PSBR to stake the space otify 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 4/21/2021 • • Vaughan, Karen From: Vaughan, Karen Sent: Tuesday, May 23, 2023 9:04 AM To: information@floridamonument.com Subject: FW: Monument being installed Thurs 5/25 Attachments: Image jpeg; Affleck.pdf Good Morning, Kevin! See attached picture and map. Green flags and looks like there is a marker there currently for her husband. You may want to check with the family about where to place her marker exactly. We have no restrictions as long as it is on that space. Thanks! Karen B. Vaughan Administrative Assistant City of Clearwater City Clerk Department Ph: 727-562-4091 Fax: 727-562-4086 From: Peterson, Erick <Erick.Peterson@MyClearwater.com> Sent: Tuesday, May 23, 2023 7:39 AM To: Vaughan, Karen <Karen.Vaughan@MyClearwater.com>; Chaplinsky, Paula <Paula.Chaplinsky@myClearwater.com> Cc: Brigman, Nathan <Nathan.Brigman@MyClearwater.com> Subject: Re: Monument being installed Thurs 5/25 Morning Karen, they are green flags for Paulina Affleck cross Myrtle on the east side next to the big monument vault. 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