Everett, Dorothy BCemetery Call Work Sheet
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Date: It / I? / a0?°
Funeral Home / Monument Company:
Contact Name: P-? CK
Tel. #: 9b a- ao') o
Reason for call: CeV?„ SiA,I ,
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Fax #: nn
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Deceased Name: y k V G r e 1
Date of Birth: Ie / 3 / Iq Date of Death /0 a o 10
Block S Lot Space 1 Sp?cc CCU
Full Burial Urn Space
Owner of Plot: ?n?a C ?y a It
Interment: (One full burial and one urn, or two urns per space)
?2
$30.00 Staking Fee - received on:
Date of Burial Time: la:?? err /pm
Disinterment: t Q411
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
Monument Being Placed: _ (No Fee for Staking of Monument)
S`3- L073
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MAY--04-1998 11:56 CLEANER CITY CLERK
AffMAM
STATE OF FLORIDA )
COUNTY OF PINELLAS )
813 562 4886 P.002i002
May 4, 1998
I, the undwgXnod, do hereby attest that I am the Examttix of the Will of Ray R Everett, deceased wbo
was the record owner of Space One, TWO, Thtee and Fear (1.2.3.4). Lot Twenty-oven (27), Block Five (5) located
in the City of Clearwater Municipal Cemeta y.
4 grant right of interment of aammal remains for Hazold PrestoN deeessed, in space four (4)
and make known my desire to be interred in that same space. rr ?-{-
1, grant right of inte=nt of m mood remains of H e r b ey-+ G V e ?e 41 in apace two (2).
I, grant right of interment of cremated retrains of QQC01 {1 y 5 U E r c_ in ?a one M.
1, furaw agree to re3em indemnify and hold the Gty of Ckarwster harmless from liability in the evert
of any claim arising Rom the use of the above dcscdbcd Property.
SIGNATURE
(and additen)
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q q6 7o dou-) C-606 12,
WrMSSES:
SIGNATURE & ADDRESS - PRINTED NAME & RELATIONS
SWORN TO and subscribed before me this - day of 1464 v . Mg by
2 ra d / N s re8 ?-,o-j oeraonatly to me or has made
himself known to me by Drd Jf44 11 sue? _ Gdet? ?
(SEAL)
l?yr
ART PA6 commission expires:
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OONDED °s' 1g!!
WOF ATIAftrc
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TOTAL P.002
Crystal, Reports Viewer
Page 1 of 1
Main Report 100%
Status of Block: 5 Lot: 27 as of 11/17/2010
INTERMENTS:
SPACE BURIALTYPE DECL DECF DECM BIRTH DEATH INTERRED
1 FULL EVERETT RAYMOND H 1/18/1886 06 / 17 / 1970 6/23/1970
1 URN EVERETT DOROTHY 1/1/1901
2 URN EVERETT HERBERT 1/1/1901
2 URN EVERETT HERBERT L 1/1/1887 01/01/1927 7/26/2002
3 URN LEE DAGETTE M 1/1/1887 10 / 08 / 1978 10/21/1978
3 URN LEE ANNA E 1/18/1891 01/16/1969 6/23/1970
4 URN PRESTON GERALDINE GE 5/18/1916 08 / 28 / 2007 10/23/2007
4 URN PRESTON HAROLD 9/15/1902 03 / 03 / 1997 5/4/1998
5 FULL CUNNINGHAM GEORGE C 1/1/1882 01/01/1933 1/1/1933
6 FULL CUNNINGHAM EDNA N 1/1/1894 01/01/1928 1/1/1928
7 FULL NICHOLS HATTIE D 1/1/1871 01/01/1947 1/1/1947
8 FULL CRAVEN DAISY M 1/1/1877 11/04/1960 11/7/1960
9 FULL MIGHELL NORMAN C 10/6/1910 01/10/1928 1/10/1928
10 FULL MIGHELL NORMAN E 1/1/1861 01/01/1940 1/1/1940
11 URN MIGHELL JESSIE 1/18/1880 01 / 20 / 1965 1/20/1965
13 FULL CLARK PHILIP M 1/1/1915 01/01/1928 1/1/1928
14 FULL CLARK FREDERICK S 1/1/1871 01/01/1945 1/1/1945
15 FULL CLARK BARBARA L 1/18/1875 01 / 07 / 1970 1/9/1970
DISINTERMENTS FROM SPACE:
No Matching Records
RESNTERMENTS:
SPACE BURIALTYPE DECL
4 URN PRESTON
3 URN LEE
'4 4 0. 1 / 1
DECF DECM DOD
HAROLD 03 / 03 / 1997
DAGETTE M 10 / 08 / 1978
Page I of 1
DOB BURIAL
09/15/1902 05/04/1
01/01/1887 10/21/1
http://msb-crystal-ent/businessobjects/enterprise 11 /infoview/viewers/rpt/DHTMLViewer.aspx?skin=ski... 11/17/2010
LaCosse, Judith
From: Taylor, Joe
Sent: Friday, January 14, 2011 1:18 PM
To: LaCosse, Judith
Cc: Tokar, Mark; Wells, Alexis; Gilmore, Stephanie; Vaughan, Karen
Subject: RE: Cemetery Staking !
We used green flags.
From: LaCosse, Judith
Sent: Thursday, January 13, 20113:55 PM
To: Taylor, Joe
Cc: Tokar, Mark; Wells, Alexis; Gilmore, Stephanie; Vaughan, Karen
Subject: Cemetery Staking !
Importance: High
Hi Joe,
We received a call this afternoon from Rick of Moss Feaster requesting a staking for a urn burial for:
Dorothy Everett in Block S. Lot 27. Space 1. Ms. Everett passed away in PA and her remains were sent here for burial.
Other burials nearbv in Blk 5. Lot 27:
Space 1= Raymond H Everett - Full burial
Space 2 = Herbert L Everett - Urn
Space 3 = Dagette M Lee - Urn
Space 3 = Anna E Lee - Urn
Staking is needed by Wednesday, January 19th in the morning and the actual burial is scheduled for Thursday, January
20`h at 10:00 a.m.
Please advise as soon as you can the color of the flags being used so that we could notify the funeral home.
Thanks for your help.
.1mlith LaCosse
Styr f f'Asst.
Official Recortts & Leg%slutive Services
727-562-4093
January 14, 2010
Attn: Rick
Funeral Home: Moss Feaster
Fax: 727-562-2073
(This fax includes a map of the Clearwater Municipal Cemetery)
Deceased: Dorothy Everett
Gravesite: Block 5, Lot 27, Space 1
Urn space
Gravesite flagged with Green flags.
Nearby Burials:
Space 1 = Raymond H Everett - Full burial
Space 2 = Herbert L Everett - Urn
Space 3 = Dagette M Lee - Urn
Space 3 = Anna E Lee - Urn
Note: We received $30.00 staking fee from Anne E. Barton
3 I b Aya?, w Q¢?,
F0. `1 G ? 1LV i ,rXX?c
Please contact me with any questions: J
Judith LaCosse
Official Records & Legislative Services
City of Clearwater
727-562-4093
R_ J,.
N y 13066,- aSyfq
Thank You.
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Clearwater
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City of Clearwater, Florida
Official Records and
Legislative Services Department
Phone (727) 562-4090
Fax (727) 562-4086
FAX MESSAGE
TO: Joe Taylor
LOCATION: Parks and Rec.
FAX NO.: 6551
COMMENTS: See attached cosy of burial permit for your files.
Permit # 2620 - Interment of Dorothy_ B. Everett
Urn
FROM: Judith LaCosse, (727-562-4093)
DATE: 1/20/2011
NUMBER OF PAGES THIS MESSAGE (INCLUDING THIS PAGE): 2
B U R1AL FLK1V111
CLEARWATER CARETAKER
CLEARWATER, FL
Permission is hereby granted for burial of:
Name of Deceased: DOROTHY B EVERETT
Owner of Property: ANNA C EVERETT &
Block : 5 Lot: 27 Space: 1
Date of Death: October 31, 2010
Funeral Home Director: RICK - MOSS FEASTER
Time: 10:00 Staking Fee: 30.00
PERMIT # 2620
January 20, 2011
Burial Type: URN
Date of Birth: October 3, 1922
Date of Burial: January 20, 2011
Date Paid: January 5, 2011
Clearwater Cemetery
By we 6i C?,Q-