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Moravec, Shirley (Coachman)Cem • Date: 3 / 3 / `L011 • 0 Funeral l1orne / Monument Company: Contact Name: kw ' cS'?cye??S Call Work Sheet oss FecAe' - Tel. #: 56a - 2-O+O Reason for call: Cc-&S +° U b Mrs. S???Q Moravec 6C .? a c c eIE 'f-14 ?yQ? cc e ,i ., 4 Fax #: U Deceased Name: JOV4pl, MorkvGG - 4) `6 " l.-,1? Date of Birth: Date of Death Block a Lot -7 Space 3 - Owner of Plot: ************************************************************************************************** Interment: (One full burial and one urn, or two urns per space) Full Burial Urn Space $30.00 Staking Fee - received on: Date of Burial: Time: am/pm 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 Monument Being Placed: (No Fee for Staking of Monument) 031Q3I2011 10:50 7275622043 MOSS FEASTER PAGE 01103 Dignity 9woss. Teaser Tunerafl'amer and Crrewtiom Services 1320 Main Street OunedM AFL 34698 Phone (727) 562-2040 Fax (727) 562-2043 WME&mossfeasterdunedin.com FACSIMILE TRANSMITTAL COVER PAGE Date: 3 T l}?x To: C' t i ul L - A U nJ t kL -?WETEZ? From: O-C Dr 0?4rjcf Number of Pages (including cover page): Y a24 dEe- s t 1-67? ,5 ace 3 A4 F;S?k you- 4? ChA,,,tW6jk12 1^0 &/r 14 ?f -m Co a- C? /Vt l lAAPORTANT-tANFiDEaI t1AL INfUfiMATiON This message is intended only for the use of entity in whim it is addressed and may contain in atio that is prnn ad, ential a? exempt from disClo6ure under applicable law_ Any other ti}spibution is strlctly prohibited. If you ve received this e n error, please noto us immediately by telephone and return the original transmission to us by mail without making a copy, A PROUD PROMpER Of 04MIrir[Y MEMORIAL 03/Q3/2011 10:50 7275622043 MOSS FEASTER PAGE 03/03 ?D Tose_ph EDWAQT)Nbp ,i cm. C. 4v L ?AYy ,h.ad? ?r 6 X . Eo idlT LA N T7 _.. - STA PT I 1\104 AT .r Hecy h ?- a_-f Po-HaM .10 LLAN- I Q S 03/03/2011 10:50 7275622043 MOSS FEASTER PAGE 02/03 APPLICATION FOR INSTALLATION OR REMOVAL OF A MONUMENT r.? Authorization To be Completed by owner of Burial Rights k,E .4JeWATIT ur?1CIPALGEMEI D,Ca FOR.4' Do hereby auttroft caern tWU jaj?? WI_iT is Ififfit" > futtt ter. KE Mal mcnumerrt far *s+ibad bvrlat r ilia OCflr'dt+•tQ to t cwner(s of burial rights located in, ovxo/p. pa te#s4 W is SAME Aft, E Of -EbV)4 D D KA LfEe ikTf (? NCAINfAf A09411E(,7 ? to?? ?T' Prtainirtg tO the brutal and/or any irttiecmnnts M merit ciesiel, WWae' b?sir+ess Phone Rua L tR0?3rrWVB Or1 tli!• abov@ now in sit UWe, ovmcgs) -of d-te above-ieecrtbed burial righls. declire under penalty of pet)ury that the foregoing c ats, re er#ei?Dess sW rir nl% are true and oorr t on b4h:21f of rr,yseN/vure?r?s, the next of kit, curd am at law, Me agree to hold hsrrnfess; k0 mrafy and (Wend !fie above natme+d cernetery as wag as tjeir aectars. ca=rs, sper>ts, +amployrW aid sharetKWers, from and against all curns. lames or dances whats? (including feacmable attosr3e)'s foes) which nM msuft In coorw-don wah the above raferen"d p vp" and nt rwiation. tt?s d*y of 20? r1 Ow per 11D Document S - r r&W56 (Print) Alt9fly-i-la-c. witnm V tess (Pnrtt) Owner 10 Docurnwt BRONZE M A RlAi5 Daoripdon (To Sc Cmawletcd "o'muuett I Dealer) Mani tclum'r of memorial Desigr?lStyi$ lg Corepast fl trtzi fua _x _ Vase? D 'Yes 13 Lyle Borader Let?sr St?rfe Emh4ems Foundatto r7owu Adaterial F suppwr MON11ARt=WS, MA BLE, O OF?RN/I"E R S (Please pwide s 0rawic?iteewr than stwdard des n iru E14-Me size _ x a^,x Die size 3 Sr p it Reclestai sizes Vase? Yes o Size OW *ktx 1=am X lgec4c TOP grids Die Masbeew R /IY 016 Ootsir Ewen •irOW' Top Sides Maternal ? Letterirtr? St?r(e r st E pagv I or z LaCosse, Judith From: LaCosse, Judith Sent: Thursday, March 03, 2011 2:30 PM To: Taylor, Joe Cc: Official Records and Legislative Services Subject: RE: Cemetery Questions Thanks Joe. We appreciate your quick response. You have been very helpful. Judith LaCosse Skiff Asst. Official Records & Leg=islative Sen,iees 727-562-4093 From: Taylor, Joe Sent: Thursday, March 03, 2011 1:38 PM To: LaCosse, Judith Cc: Wells, Alexis Subject: RE: Cemetery Questions Hi Judy, I am really not the person to answer these questions, I would think the answers would come from your office. Logically I would say yes to both questions. I don't know of any space that has three urns in it although there is plenty of room. As for the monument it should be ok as long as the space is larger than the width of the monument, typically a space is 48" wide and block 2 allows raised monuments. Sorry I couldn't be of more assistance. From: LaCosse, Judith Sent: Thursday, March 03, 2011 11:53 AM To: Taylor, Joe Cc: Official Records and Legislative Services Subject: Cemetery Questions Importance: High Hi Joe, I have a couple of questions regarding the cemetery. I thought maybe you might know the answers. According to the Clearwater Cemetery Rules and Restrictions, two burials in one space shall be permitted provided one person has been cremated or is a baby; and only one burial shall be allowed in an infant or urn space. The first question came from a citizen who wants to know if three cremations are allowed in one adult space. (See attached copy of our Rules and Restrictions). Do you know if this is allowed and if there's room? << File: Cemetery rules and restrictions. pdf >> The second question came from Karen at Moss Feaster. (See attached fax) Joseph Moravec (urn) is buried in Block 2, Lot 7, Space 3. His wife, Shirley, will be buried when the time comes in the same space (urn). Ms. Moravec has bought a monument (see attached dimensions). Karen at Moss Feaster would like to confirm if this monument is acceptable for placement on space 3. << File: Cemetery matter-Moravec.pdf >> Any assistance that you could give me will be much appreciated. Any questions, please give me a call. Thanks, Judith LaCosse Stet ff Asst. Official Records & Legislative Services 727-562-4093