Roberts, Horace David and Alicete: g 1s 1aut
Contact Name:
Cemetery Call Work Sheet
Funeral Home / Monument Company:
Contact # or Email:
Reason fo =-I
A: ** ST .• - EQUEST for Interment
.00 stakin • eekdays) - $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: OCr:: �r� rL �'�jP� 7 ! 4
Verify Ownership/Burial Rights in cemetery program before confirming:
(0/t4/t5 2Z Sr.
Bloc':✓ Lot Space
Date of Birth: / / Date of Death / /
Date of Burial: / /
B: ** STAKING REQUEST for Monument to be placed p
No fee for staking of monument
•
Deceased Name:
****************
ok.),,utise
t 4-/tA / 41-'
Block Lot Space
Verify Ownership/Burial Rights in cemetery program before confirming:
C: ** OTHER REASON:
*****************************************************************************************************************************
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
City Clerk/Cemetery/FormsPermitsTemplates/Cemetery Call Work Sheet -20
Revised 12/27/2023
Vaughan, Karen
Wont DIANN ROBERTS <dianngroberts@aol.com>
Sent: Monday, August 5, 2024 3:31 PM
To: Vaughan, Karen
Subject: Re: Clearwater Municipal Cemetery / Roberts
Attachments: Roberts.pdf
CAUTION: This email originated from outside of the City of Clearwater. Do not click links or open attachments unless you
recognize the sender and know the content is safe.
Karen I really appreciate your time. Thanks so much for looking this up for me.
Diann Roberts
Sent from my iPhone
•
On Aug 5, 2024, at 10:19 AM, Vaughan, Karen<Karen.Vaughan@myclearwater.com>
wrote:
Hi Diann!
I've attached a status of Block 6 Lot 19 for reference and also a map indicating where your
grandparents are located in the cemetery. I can ask Parks & Recreation Dept staff to go out and
flag them if you need additional help finding them. They need a few days notice so let me know if
you need them flagged as soon as you can.
Thanks!
Karen B. Vaughan
Administrative Assistant
City of Clearwater
City Clerk Department
Ph: 727-444-7150
Fax: 727-562-4086
•
•
SEE SHEET
95
96
97
98
94
81
80
65
64
49
93
82
79
66
63
50
92
83
78
67
62
51
91
84
77
68
61
52
\0
85
76
69
60
53
89
86
75
70
59
54
MYRTLE
48
33
32
7
47
34
31
18
46
35
30
19
14
45
36
29
20
13
4
44
37
28
21
12
43
42
41
36
39
40
27
26
23
22
23
24
11
10
6
7
z
m
AVENUE
25 16 15
6 5
35
32
27
24
17
14
7
4
36
31
28
37
30
A8313W33
27
24
25
21
20
5
10
4
\ 18
19
14
3
I5
17
16
9
5
4
7
\II
8
3
9
10
12
13
18
29
19
18
20
17
21
16
22
23
14
24
3
16
15
14
18
13
19
12
20
21
7
15 10
12
6
7
24 25
22
23
9
10
6111111111
18
I7
19
6
20
2
15
14
6
5
4
3
4
0
A
28
29
22
13
23
12
24
25
10
26
9
27 8
28
7
29
6
30
5
31
4
32
3
33
27
30
34
PROSPECT
AVENUE
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iq
Spies I4cj t 8
Y77IMY4s nl
m
in
•
INTERMENTS
BURIAL
SP TYPE
1 FULL
4 FULL
9 FULL
10 FULL
11 FULL
12 FULL
13 FULL
14 FULL
15 FULL
16 FULL
DECL
HENDRIX
FIGHT
BROWN
BROWN
BROWN
TOOKE
TOOKE
ROBERTS
ROBERTS SR
ROBERTS
DISINTERMENTS
• REINTERMENTS
•
Status of Block: 6 LOT: 19 as of 8/5/2024
DECF DECM BIRTH DEATH INTERRED PERMIT
FITZHUGH L 1/1/1898
DORIS T 1/19/1917
FRASER S 1/1/1880
HARRY H 1/1/1860
MALINDA V 1/1/1854
HENRY E 1/1/1878
ALLIE M 1/18/1878
ALICE M 5/1/1905
HORACE D 9/3/1889
WILLIAM H 7/18/1929
10/22/1957
11/22/1972
3/30/1956
1/1/1927
1/1/1937
1/1/1948
2/10/1965
11/13/1964
5/17/1963
2/8/1951
10/22/1957
11/24/1972
3/30/1956
1/1/1927
1/1/1937
1/1/1948
2/10/1965
11/17/1964
5/20/1963
2/8/1951
1202
940
1205
0
0
0
416
400
280
0