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Moravec, Shirley Coachmanrip Cemetery Call Work Sheet • Date: 3 / 3 / ac) 11 Funeral Home/ Monument Company: Moss feat",- c? ?'?cyehs Contact Name: Tel. # • SG a - a-o+o Fax #: Reason for call: C ?' cow i/ w? %`? c ce °? wLOwKM e (?w? cYr?c.4L? S?. I b? MSS Ir Mof'0.000 CCoG«h r+.a-k? 1?L X 3fa wi"ti!'? ?4? -(druwi? z ?o a cce eL wcc ?,. e .? ace 3 . Deceased Name: `7Oup? 4)66 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) 3/3/(1 - FV v f i ?2.C kav\:¢. ? ? ? J S s -?2?Qit.. . 0319312011 10:50 7275622043 MOSS FEASTER PAGE 01/03 Dignity moss. Teaser Tuneraf7fom" and C*matzan Sem*a 1320 Main Street Ouned- TL 34695 Phone (727) 562-2040 Fax (727) 562-2043 YnNik,mossfeasterdunedin.com FACSIMILE TRANSMITTAL COVER RAGE Date: T? x To: t C?L'JW- t" L 1? t? CO C, M f4 k you.-t>>?h IMPORTANT-CONFIDENTIAL INFs5WAWqyvouvo This message is Intended only for the use of enttty In which It Is addressed and may tontain o that is privy ed, cpWenttal aA exempt from d"?losure under applicable law. Any other (Is ibuton Is stA,-tly prohibited. IremlvW this e n error, please notify us immediately by telephone and return the orfglnal transmission to us by mail wewt mawg 0 may, A PROUD PROVUR Of DyGWY MEMOPJAL From. L&Jqcf Number of Pages (including cover page): 03/F3/2011 10:50 7275622043 MOSS FEASTER PAGE 03/03 '?ftr GRRy? ?1 RN ? der r n? -AT it Hell h ?- ct+ Bo&m . 66 9Q14 MEN i 03/p3/2011 10:50 i11Ne. 7275622043 MOSS FEASTER APPLICATION FOR INSTALLATION OR REMOVAL OP A MONUMENT ?? r , Authorization To be Completed by QWnornf Burial Rights k,a40, ATi17R ur11Cip,4,,erAfE7 Do hereby authorise is PAGE 02103 --- I cwner(s of bufW rights located in' Ina ?FnuRl3>yL?N. 5 !h s???? EOf -Eaa)afza o KA UEe T dal ckr?4m /1!tD?RVre, 1 ti h Peftfriling to the artdlor any intecmants • m mem deader, wtme- buoir ew =- - _ phone .... ...? .w+.... arprrt 4rrp r C [fiV1 SC81yCCrrKr? L all m6nurnerlt for - ora the• above des*ibed burlap Trigft Tong to ft RUWS arxf R69Watllons now in efflt IfWe, owrmgs) -of die above-descrthed burial rights. declare under pengllty of pequry thSd the foregoing cariffiWacns, mprwen' and tertmus are true and oprfoa On b tf Of myseftweOve ,, the next of Wil, mW ale heks at lei, Uwe agree to half hwrftts kwWorafy and defend ft* above named cernetery as Weii 4ft , aeutws, OM=m, Derma, ioy n W%d Shareholders, from and agakwt all ciairns. WdxVes or lea whaO"w l;includkV rea able 3ttwnft °s f'Oes) which ffMY r+ uft in comiely ton with "abovre rem ae4 Woo" $nd morm gent " tativr+. 51d this dray of - WT -6 . l J. !l/x,(4,orl7i'b1Q? o?v er ID Document wtrw,w (print) ?/+GflLQ '4a4qxxj Ierr#4d k v_ vvitnm mess (NrA) . Uwrrer ID EkMU Wt ?r?cron (3'a $,e C?xr?pietcd ?>S+Io>anun?et>t Dealer) BRCWE MEMOR1ALS Manufadurer of memofti Dt'sigr lStyi$ t9 CW npartlarr 0 i .._k_ Va"7 Dyes Q tY Bonier Letter Style Emblems our+datio ? l-ou material ?df ticr KA iMUNtJMl=N75, MARBLE, OR t3Fs'AtV12'E R V 5 (PtQse prv3?Ide a draw, i th h . Bede F e er 3 wi shard d deli r size Die s,? 3 r? Pedestal sizes X tea? Yes o p Size JZ_ Beck Dietiatr: Faces Die ? I', TW3 -- Die Coicr (ice i=rrds ' t 17-F f nae *rish; Top Sides _ __-- _- M;3rtetial -" ?-- Lettering style- r Page r' or z 3MVI'"Tj (?f'AChtD tD 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. .Iaditlr LaCosse Staff Asst. Official Records & Legislative Services 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 Staff Asst. Official Records & Legislative Services 727-562-4093