Morris, VictorCemetery Call Work Sheet
Date: ?7 / 2-I/ ?-d 11
Funeral Home/ Monument Company: C-AAke-t
Contact Name: T, C4
Tel. #: 7?)-? - -3,4-7- ?'595 Fax #:
Reason for call: Staking Request (Interment/Disinterment)
- Affidavit (Burial Rights)
Monument (Marker) being placed
(No fee for staking of monument)
Other reason: ( f'
SQ-'A to
Interment: (One full burial and one um, or two urns per space)
Full Burial
Owner of Plot:
Deceased Name
Urn Space
i Zf°r ?A orr,S
Ti <-f or, f' or rIS
Block I a Lot -79 Space I J- a
Date of Birth:
Date of Burial:
Date of Death
'j=o r
Time: am/pm
10
$30.00 Staking Fee (Funeral Home) - received on: / / Sp 4 u a = r-?-?Ve p
.(&-L &co .e &,L
Copy of permit faxed to Joe Taylor/P&R - Fax No. 6551 on: / / F'lorr ?s
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
4- r1?4 k,- ttx- ezt,ic,_ by?oh mow. ek? V Q?c?c?
Crystal Reports Viewer
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,
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Status of Block: 12 Lot: 79 as of 06/21/2011
INTERMENTS:
SPACE BURIALTYPE
i FULL
3 FULL
4 FULL
DISINTERMENTS FROM SPACE:
No Matching Records
REINTERMENTS:
No Matching Records
DECL DECF DECM BIRTH DEATH I
MORRIS VICTOR 11/1/1923 02/19/2011 2.
JOHNSON JONAH W 1/1/1911 04 / 20 / 1970 4.
JOHNSON TENNIE K 8/24/1911 12/10/1996 1
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LaCosse, Judith
From: Taylor, Joe
Sent: Tuesday, June 21, 2011 12:49 PM
To: LaCosse, Judith
Cc: Tokar, Mark; Wells, Alexis; Vaughan, Karen; Gilmore, Stephanie
Subject: RE: Cemetery Staking - Double Monument Placement
Space is marked with yellow flags
From: LaCosse, Judith
Sent: Tuesday, June 21, 2011 10:50 AM
To: Taylor, Joe
Cc: Tokar, Mark; Wells, Alexis; Vaughan, Karen; Gilmore, Stephanie
Subject: Cemetery Staking - Double Monument Placement
Importance: High
Hi Joe,
We received a call this morning from Tiffany of Casket & Monument Co. regarding placement of a monument.
Would it be possible to have Block 12, Lot 79, Space 1 & 2 staked for placement of a double monument tomorrow after
2:00 p.m.?
Please let me know the color of the flags you will be using so that I could inform Tiffany.
Name of deceased in space 1- Victor Morris
Other Full Burials nearby:
Space 1- Victor Morris - Full Burial
Space 2 - Vacant - (Reserved for Gwen Morris)
Space 3 - Jonah Johnson - Full Burial
Space 4 - Tennie Johnson - Full Burial
Please advise and thanks for your help,
Judith LaCosse
Staff Asst.
Official Records & Legislative Services
727-562-4093
Owner-Victor Morris
Cemetery Call Work Sheet
i
Date: A/ a a/ I I
Funeral i-iome / Monument Company: M o s S f.e 1-?o t.
Contact Name: F-c"2 .1 J )-Q
Tel. #.
Reason for call:
N *+ &e dZ ?'?- R ?o a I!c
s1, a- A0-? 1
Fax #: ? 5?2 - a0 ?3
Deceased Name:
V, tl , P1orriS
Date of Birth: 11 / I / I1d-3 Date of Death a / I Y / a-o ( I
Block 1 a Lot Space I
• Owner of Plot: ? t?+b r "orr? s C ??,?e ?. s•) 1ji A k Ib
Interment: (One full burial and one urn, or two urns per space)
Full Burial Urn Space
$30.00 Staking Fee - received on: a- A011
Date of Burial: a / a 3/ 11 Time:
*************************************************************
Disinterment:
1: 0 o _a mrm
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)
11
Crystal Reports Viewer
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Status of Block: 12 Lot: 79 as of 02/22/2011
INTERMENTS:
SPACE BURIALTYPE
3 FULL
4 FULL
DISINTERMENTS FROM SPACE:
No Matching Records
REINTERMENTS:
No Matching Records
DECL DECF DECM BIRTH DEATH INTERRED
JOHNSON JONAH W 1/1/1911 04 / 20 / 1970 4/20/1970
JOHNSON TENNIE K 8/24/1911 12/10/1996 12/12/1996
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LaCosse, Judith
From: Taylor, Joe
Sent: Tuesday, February 22, 2011 1:50 PM
To: LaCosse, Judith; Tokar, Mark; Wells, Alexis
Cc: Gilmore, Stephanie; Vaughan, Karen
Subject: RE:
We'll get it tomorrow by noon. I'll use Yellow flags.
Judy if we get a rush order like this please call Alexis on his cell phone(224-7634). He can contact me in the field. Thanks
From: LaCosse, Judith
Sent: Tuesday, February 22, 20119:53 AM
To: Taylor, Joe; Tokar, Mark; Wells, Alexis
Cc: Gilmore, Stephanie; Vaughan, Karen
Subject:
Importance: High
Hi Joe,
We received a call this morning from Paul at Moss Feaster requesting a RUSH staking for an Full burial for:
Victor Morris, who passed away on Saturday, February 19th. He's to be buried in Space 1 of Block 12. Lot 79.
Owner of plot -Victor and Gwen Morris
Date of Burial: Wednesday. February 23'd at 1:00 pm.
Other burials nearby in this Blk 12, Lot 79:
Space 1= Vacant
Space 2 = Vacant
Space 3 = Jonah Johnson - Full burial
Space 4 = Tennie Johnson - Full burial
Please advise as soon as you can the color of the flags used to stake this area. We will then, notify Paul at Moss
Feaster.
Thanks for your help.
Judith LaCosse
Stq ff Asst.
Official Records & Legislative Services
727-562-4093
February 22, 2011
Attn: Paul or Jill
Funeral Home: Moss Feaster
Fax: 727-562-2073
(This fax includes a copy of Cemetery Map)
# in the circle is the Block, # in the square is the Lot
Deceased: Victor Morris
Gravesite: Block 12, Lot 79, Space
Full burial
Gravesite flagged with Yellow flags.
Nearby Burials:
Space 1 = Vacant
Space 2 = Vacant
Space 3 = Jonah Johnson - Full burial
Space 4 = Tennie Johnson - Full burial
Staking Fee: 30.00
Please make check payable to: City of Clearwater
Mail to: City of Clearwater
Official Records Dept. - 2"d Floor
112 S. Osceola Ave.
Clearwater, FL 33756
Please contact me with any questions.
Tha74 o
9 1"
udith LaCosse
Official Records & Legislative Services
City of Clearwater
727-562-4093
SEE SHEET
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PROSPECT AVENUE
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Vendor No.
3141616
PAYMENT DETAILS
Morris #467301001360 - Staking Fee E C E E
FEB 2 4 2011
'!COAL REC-C*
Ttr%-S DEFT
Vendor
CITY OF CLEARWATER
Moss Feaster Funeral Home and Crema Amegy Bank N.A.
693 South Belcher Road 35-1125 10207540
1130
Clearwater, FL 33764 Porter, TX
02121/2011
PAY Thirty and 00/100 Dollars
PAY TO THE
ORDER OF
Memo:
CITY OF CLEARWATER
112 S OSCEOLA AVE
CLEARWATER, FL 33756
021/21/2011
10207540
***********$30.00
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Morris #1360 - Staking Fee
II'10207S4011' 1:113110SE161: 4 4 4 40 70 7 211'