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Lugo, Gilberto & Guadalupe Cemeter y Call Work Sheet Date: 3 / I / afl l I Funeral no- ument Company: Contact Name: 0`t. - 4-K, G ` f-Lt`t° Lll - up%4-Q-e Tel. Fax Reason for call: Kr. LG-?? Z4 -le-' c W d- ti-i Q c e. vo w c i ?+. o lkeA. u ?CW d- M-e ce . Deceased Name: Date of Birth: Date of Death Block IS Lot 3 Space" -03) IS - ( A) Lafi log) - S 1 0W , /4 • Owner of Plot: I Mknta 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) 3/-7//l `ItL I t ID juViCw' g,7Vi . CQ-11?ter7 prs-y'zo. ?`p?Qc?aoQ 7?e LaCosse, Judith From: LaCosse, Judith Sent: Thursday, March 03, 20114:08 PM To: Dougall-Sides, Leslie Cc: Official Records and Legislative Services Subject: RE: A02-00153: RE: Cemetery Matter Thanks for your quick reply. Judith LaCosse Staff Asst. Official Records & Legislative Services 727-562-4193 From: Dougall-Sides, Leslie Sent: Thursday, March 03, 20113:55 PM To: LaCosse, Judith Cc: Treuhaft, Linda Subject: A02-00153: RE: Cemetery Matter No, per the Rules it is not allowed. The normal practice for cemeteries is to allow one burial and one urn in a regular adult burial space. If more than one urn, additional urns go in a smaller urn space or columbarium. The reasoning behind this is apparently not to take up "real estate" for urns, which are more appropriately put in a smaller space or columbarium built for them. From: LaCosse, Judith Sent: Thursday, March 03, 20112:51 PM To: Dougall-Sides, Leslie Cc: Treuhaft, Linda Subject: Cemetery Matter Importance: High Hi Leslie, 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. Two urns should be allowed in one urn space. << File: Cemetery rules and restrictions.pdf >> A citizen wants to know if three cremations are allowed in one adult space. Do you know if this is allowed and if there's room? Please advise. Judith LaCosse Staff Asst. Official Records & Legislative Services Cemetery'Tracking System Page 1 of 1 ? .T, NET Good Afternoon! Today is Tuesday, March 1, 2011 Home I Feedback You are logged in as Judith.LaCosse E3 Cemetery G File Transaction View Lot Profile B Reports Print Burial Permit Search Names and Notes Search Old Locations Print/View Lot Status Monthly Memo Disinterments Deceased by Location Alphabetical List of Deceased File List of Owners File Reinterments Permits List by Deceased Permits List by Location PRBurial 9 Maintenance Control Data Valid Locations Security Updated on Tuesday, January 06, 2009 Home I Feedback I Departments I Contacts I Forms [ Previous Page ] [ Too of Page ] 3/1/2011 http://clearwater/Apps20/cemetery/viewlotprofile.aspx?b=15 &1=109 Cemetery Tracking System - View Lot Profile Block: 15 Lot: 109 Profile Summary Click 'View Assigned' to view interment details. If more than one individual is interred in a space, a second grid will appear below, displaying all of the individuals assigned to the space. Click 'View' on the second grid to view the interment details of that individual. WEST SIDE OF MYRTLE AVENUE Space Owner Last Owner First Owner Middle Max Interred Total Assigned Interred 1 WHITE, JR. FRANK 1 1 1 View Assigned 2 BELL CHRISTINE 1 1 1 View Assigned 3 LUGO GILBERTO U 0 0 0 View Assigned 4 LUGO GILBERTO 0 0 0 View Assigned. E 1 B . 3 pP,6 --k I S y 1 C, S' S p j(ytt44n-l I r? - J?"??'1 ! Cemetery' Tracking System Good Morning! Today is Thursday, March 3, 2011 n Cemetery o File Transaction View Lot Profile O Reports Print Burial Permit Search Names and Notes Search Old Locations Print/View Lot Status Monthly Memo Disinterments Deceased by Location Alphabetical List of Deceased File List of Owners File Reinterments Permits List by Deceased Cemetery Tracking System - View Lot Profile Block: 15 Lot: 108 Page 1 of 1 Home Feedback You are logged in as Judith.LaCosse Profile Summary Click 'View Assigned' to view interment details. If more than one individual is interred in a space, a second grid will appear below, displaying all of the individuals assigned to the space. Click 'View' on the second grid to view the interment details of that individual. WEST SIDE OF MYRTLE AVENUE Space Owner Last Owner First Owner Middle Max Interred Total Assigned Interred 1 MARTIN MARTHA 1 1 1 View Assigned 2 LARGO LARGO K 1 0 0 View Assigned 3 MENDEZ DELIA 3 2 2 View Assigned 4 MENDEZ DELIA 2 1 1 View Assigned 1 lz I/? )Ua ??, 1 -? r c? i es -I ?-?a;- ?Vot t 1nZ ?,?.??? r1 /? l ? c hG?-1 "tots TK 3vf S, ?? +f IiL 1vtQ(h'r1 LIt", IaL (;{,xarI1 Permits List by Location PRBurial 17 Maintenance Control Data Valid Locations Security [ Previous Page ] [ Trop of Page ] http://clearwater/Apps20/cemetel,.. 3/3/2011 AFFIDAVIT STATE OF FLORIDA) COUNTY OF PINELLAS) I, Gilberto Lugo, the undersigned, am the owner of cemetery property described as Block 15, Lot 109, Spaces 3 (B) and 4 (A) in the Clearwater Municipal Cemetery. My wife, Guadalupe Lugo, and myself, Gilberto Lugo, will be buried in Space 4 (A). I do hereby grant interment rights to my nephew, William T. Stoll IV, my niece, Linda R. Parmelee, and their mother, Inez M. Stoll as described below: Block 15, Lot 109, Space 3 (B): Linda R. Parmelee and Inez M. Stoll Block 15, Lot 109, Space 4 (A): Gilberto and Guadalupe Lugo Please take this affidavit as your authority to note the right to property described above. Per the City of Clearwater Rules and Restrictions the maximum capacity of a space is two burials provided at least one person is cremated or two cremated remains. I also would like to mention that Block 15, Lot 108, Space 1 has a full burial of Marta Martin, owner of this space. Ms. Martin was the sister of Inez M. Stoll, mother of William and Robert Stoll and Linda Parmelee. One urn burial may also be placed in this space. I do hereby grant interment rights to my nephew, William T. Stoll IV, as described below. Block 15, Lot 108, Space 1 (D): William T. Stoll, IV I, further agree to release, indemnify and hold the City of Clearwater harmless from liability in the event of any claim arising from the use of the above described property for the interment rights requests made. Gilberto Lugo, (Owner)' (Address) co ;7Z ? r A"-+ -? ° -?-- 33? ? tness 111A Relationship to Witness (Address) I$a S g? h ? fie,. S. ? ?kr.e 4^ 1 :F7L 3 ?e(, ?V SWORN TO and subscribed before me this j day of MACXA 2011, by Gilberto Lugo who produced identification in the form of F and who did/did not take an oath. (SEAL), Notary Public ;cARENa.VAUGHAN i;(?MMISSI(3 # DD 91820103 SIRES: December 20, °' NfidedThruNofaryPublcUnderMite? My commission expires.