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Roberson, Ermine
Cemetery Call Work Sheet Date: Funeral Homer Gavcg4osnument Company: Contact Name: Contact Name: Tel. #:7 ?;9 Tel. Fax #:??? QqS-- ( 6-9 D.- Fax #: RE: t -±?o i? ` -e -o , Deceased Name: DOD: DOB• Yr?ir•{??-E.Sc.5?7 Owner of Property: Block (L6- Lot It Interment: Full Burial: ($30.00 Staking Fee) - (One full burial and one urn, or two urns) Date of Burial: Time: am/pm Disinte ent• Urn Space: 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) Space Vaughan, Karen From: Vaughan, Karen Sent: Thursday, June 08, 2006 1:17 PM To: King, JoEllyn Cc: Lewis, Eric; Taylor, Joe Subject: flagging request / Ermine Roberson / Block 15, Lot 11, Space 4 JoEllyn, I had a call today from Jamie at Serenity Gardens. They would like us to flag Block 15, Lot 11, Space 4 by Wednesday of next week. That's June 14th. They will be placing a marker for Ermine Roberson. They are saying that Mrs. Roberson died in May, but I don't show any record of her being interred yet. Serenity Gardens is only doing the marker so they don't know if she's been cremated or what the situation is. Block 15 - Lot 11 - Space 4, West side of Myrtle. In 15-11-3 is Mr. Oren S. Roberson. To the North in 15-12-4: Stephanie Polomsky To the East in 15-10-4: Shirley Tucker Thanks! Karen Vaughan Sr. Staff Assistant Official Records and Legislative Services Phone: 727-562-4091 karen.vaughan@myclearwater.com -----?-5 i ;2T 53 54- 55 565T. 50 49 46 47L46]45 44 43 42' r31 32 T 33 f ,34.r -1 37 3'8 39 L, 4 1 23 122 121 30 [29 1 227 I ?J 12Ft.,- ?I i2 3 1415 J16 IS 19 20 0S 3 2 1 -?_ V J 7.1 .. 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T-? 9 79 76 57 $4 35 32 13 pfo 78 77 56 5s'; 34 33 12 59 52 3-1 30 15 8 1 •ta F i 35 36 37 $8 16 15 14 1:3 12 11 10 9 B 7 6 5, 4 3 2 I 24 23 22 _ 19 18 17 .9 10 11 O 14 15 16 -8 7 6. 5 4 3 :2 I 4 4 ` 73 72 49 48 25 24 Urgent FOR awv A.M. DATE C 66 TIME C.? P.M. While You Were Out OF k r11?"?i?6C "I?%' PHONE AREA CODE NUMBER EXTENSIO h i f' MESSAGE l?C?}???'°'?/l a '`?? : SIGNED / TELEPHONED PLEASE CALL CAME TO SEE YOU WILL CALL AGAI RETURNED YOUR WANTS TO SE 40U l Cemetery Call Work Sheet Date: ElsLO Funeral Home: '0©S Monument Company: Contact Name: ?u S e w c."i Contact Name: Tel. cNce S' S ,. Tel. Fax #: Fax #: RE: Er?h. k-c ko L 5 ov.> i-Ev, r,r. r`. ss -Z Deceased Name: Owner of Property: DOD: Y/aCp DOB: CL( QVBlock IS Lot I l Space 3 ) Interment: Full Burial: ?- Urn Space: •.($30.00 Staking Fee) - (One full burial and one urn, or two urns) 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) ,,NM ?` 1 4 Vaughan, Karen From: Vaughan, Karen Sent: Friday, May 05, 2006 12:47 PM To: King, JoEllyn; Lewis, Eric; Taylor, Joe Subject: staking request / Lot 15-Block 11-Space 4 / Roberson Importance: High Hello! Moss Feaster called today. There will be a burial this Tuesday, May 9th (not sure of time yet). West side of Myrtle Full Burial Lot 15, Block 11, Space 4 Deceased is Ermine Roberson 15/11/3 (to the South) is her husband, Oren Roberson 15/10/4 (to the East) is Shirley Tucker 15/30/4 (to the West) is Mary Sowell Let me know when all is well .............! Thanks! Karen Vaughan Sr. Staff Assistant Official Records and Legislative Services Phone: 727-562-4091 karen.vaughan@myclearwater.com N (1) V? 31 32 33 34 - 37 36 39 40 30 28 28 27 24 23 22 21 S 16 11 Is 19 20 p10 4 T91 1 1 7T.j P S 4 S 2 1 111 112 113 114 115 116 117 118 119 120 110 109 108 lo? 106 103 104 ' 103' 102 l 101 91 92 93 94 9S 96 11 97 F9 8 89 100 [90 189 88 87 86 85 11141 8B 82 61 71 72 T3 74 - 11 77 79 78 80 70 69 60 6T 64 63 62 61 SI 32 S3 S4 SS 56 S7 58 59 60 50 48 48 47 46 4S 44 43 42 41 31 32 33 34 3S 36 37 38 39 40 30 29 26 27 26 25 24 23 22 21 11 12 13 14 15 16 n 18 20 10 9 8 7 6 S 4 3 6 369 5T0 571 572 373 574 373 576 56 564 363 562 561 S60 559 5!1 1!!!j 547 1 5491 5491 551( - 553 554 555 556 1 340 1 S41 542 1 543 540I S39 I536 5371 527 528 529 530 531 532 333 534 535 536 S26 52S 524 S23 522 S21 1 5201 51 9 518 517 SOT SOB 351I 312 313 S06 SOS 3 S02 S01 S00 i o I 1__J _ SEE SHEET 3 i %Y-RTI.F -`n ?N j 95 94 61 60 65 64 49 194193182 79$6163 50 25 16 is . 5 3S 32 27 24 17 14 7 4 18 17 36 31 2• 2! 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Am? 79 76 I ST 14 l35 T32 13 P LS4 33 12 11 AVENENUF_ 1?- 92 22 21 20 1! Is ! ?e? Y 1 6 Ic __xa ?} ztl n 5 a 2 12 4 J. I1 I 24 X22 f3 W 110 M 25 10 mn?1, C V r r ) 11305 21 C - Branchpar Moss Feaster Funeral Home(4676) 302 North Fort Harrison Avenue Clearwater FL 33755 PAY TO THE pother service of Gelco Information Network, Inc. Eden Prairie, MN 60522000 03 Gelco Check Number 11162213 01 ' 2 22 .13' .'<EF, ID ISSUE DATE gunterkm 5/8/2006 NOT VALID AFTER SIX (6) MONTHS FROM ISSUE DATE ORDER Or City of Clearwater 8 see??tY,eatere?. } ncluded. D.M. on back. 112 South Osceola Av ue Offical Records/Ka en au pan, 1 ClearZs _-`-t, 3375'6 in Do lla And NO Cxts*' *** *************** * *********************** 1$***30.00 'S AUTHORIZED REPRESEN SIGNATURE OF DflAWERS AUTHORIZED REPRESENTATIVE PAYABLET OUGH 76.658 Wil? 'a m C.. Stewart First PREMIE Bank 914 By signin this instrument, the aforesiggned confirms that this instrument ha\dand n in accordance with the authority issued by Gelco Information Network, Inc. If any SIOUX FALLS, statement rein be untrue, we, the tip signed, agree to pay the drawer uthe amount of this instrument and all expenses and damages arising from such misstatement. 11001 LIE 2 2 1,3 Itu, 1:09 1408 58 5l: 2 500000 6 5 Slim SIGNER William C. Stewart gunterkm 01 1162213. DESCRIPTION City of Clearwater 112 South Osceola Avenue Offical Records/Karen Vaughan Clearwater FL 33756 DATE LOCATION NUMBER GLCODES CONTRACT NUMBER NAME I DESCRIPTION AMOUNT 5/8/2006 I I I 4676 8405-0 467601000278 Roberson Staking Fee $********30.00