Weatherley, Arthur Allen & SusanCemetery Call Work Sheet
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Funeral Home / Monument Company:
Contact Name: Cori s 13 wL k Qu nQ
Tel. #: a - a 16 Fax #:
Reason for call: Staking Request (Interment)
Affidavit (Burial Rights)
Monument (Marker) being placed
(No fee for staking of monument)
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Other reason:
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Interment: (One full burial and one um, or two urns per space)
40 ull Burial Urn Space
Owner of Plot:
Deceased Name:
Block Lot Space
Date of Birth: Date of Death
Date of Burial: Time: am/pm
$30.00 Staking Fee (Funeral Home) - received on:
Copy of permit faxed to Joe Taylor/P&R - Fax No. 6551 on:
**************************************************************************************************
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
LaCosse, Judith
From: LaCosse, Judith
Sent: Wednesday, March 16, 2011 4:41 PM
To: 'chris. burklund@fpcg. net'
Subject: Municipal City of Clearwater Cemetery burial info. - Weatherley
Importance: High
Hello Mr. Burklund,
As I mentioned over the phone, Arthur Weatherley and Susie Weatherley are buried in Block 14, Lot 562, Space 1 & 2 of
the Clearwater Cemetery.
See attached document showing burial in this Block and Lot. I have also attached a copy of the Clearwater cemetery
map.
Note: The number in the circle is the Block and the number in the square is the Lot.
L?J I:J
Cemetery Block 14 Cemetery
Lot 562.pdf ip-Sheets 1, 2 & 3.p
if you have any other questions, please give me a call.
Best regards,
Judith LaCosse
Stajj'Asst.
Official Records & Legislative Services
727-562-4093
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