Rodgers, Ruth Cemetery Call Work Sheet
Date: II_/ 1 / 1 (
Funeral Home/ Monument Company: :_t)�,v`i d C . G r o Ss r",,LeA.4,Q M 2-
Contact Name: Mt c L` - Gros s
Tel. #: 7 7- `(L a c) 2-a Fax#: -/a-7 - 3 a
Reason for call: i/ Staking Request (Interment/Disinterment)
Affidavit (Burial Rights)
Monument (Marker) being placed (No fee for staking of monument)
Verifying Burial space
Other reason:
**************************************************************************************************
Interment: (One full burial and one urn, or two urns per space)
Full Burial V Urn Space
Owner of Plot: I s ck-c.c ( . Ra k3 er s ( t s a l C, b CI a )
Deceased Name: RLdk, 00A,Ier 5 c,e�.�tcr� Jig °v` f.(2,2_)
Block I L t Lot S 5' Space �--
Date of Birth: 4- / 1 / 19a I Date of Death 11 / a- 1 / ° l ( -4,„„i-t- # ��
Date of Burial: 11 / a g1 I 1 Time: I1:°° am pm
$30.00 Staking Fee (Funeral Home) - received on: 11 / a3 / d-°11
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
((4-DA - S e w-f PA- R (0-1_ Sa- ii. .
Revised 6/29/11 Iya_3/11 _ Q i"t;f i tz --(.t„, _01 °n^eu w&4 4-f4 ice4
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Crystal Reports,Viewer Page 1 of 1
i T I 14 4 P ►1 1 / 1 Main Report I € 100%
I Status of Block: 14 Lot: 558 as of 11/22/2011
INTERMENTS:
SPACE BURIALTYPE DECL DECF DECM BIRTH DEATH INTERRED
1 FULL RODGERS ISAAC G 1/1/1905 01/08/1981 1/8/1981
3 FULL FARIS JAMES A 1/1/1897 05/28/1968 5/28/1968
4 FULL FARIS PHYLLIS H 1/16/1911 04/29/1985 5/2/1985
DISINTERMENTS FROM SPACE:
No Matching Records
REINTERMENTS:
No Matching Records
Page 1 of 1
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http://msb-crystal-ent/businessobjects/enterprise 11/infoview/viewers/rpt/DHTMLViewer.aspx?skin=ski... 11/22/2011
LaCosse, Judith
From: LaCosse, Judith
Sent: Wednesday, November 23, 2011 10:08 AM
To: Ortega, Marco
Subject: RE: Full Burial Staking Request- Ruth Rodgers
Okay...thanks ! I will notify the funeral home.
Happy Thanksgiving !!
From: Ortega, Marco
Sent: Wednesday, November 23, 2011 10:07 AM
To: LaCosse, Judith; Tokar, Mark
Cc: Wells, Alexis; Gilmore, Stephanie
Subject:RE: Full Burial Staking Request- Ruth Rodgers
That's all that was available.
Happy Holidays!
From: LaCosse,Judith
Sent: Wednesday, November 23, 2011 8:29 AM
To: Tokar, Mark; Ortega, Marco
Cc: Wells, Alexis; Gilmore, Stephanie
Subject: RE: Full Burial Staking Request- Ruth Rodgers
Mark,
Just wondering, why were 4 different colors used to mark the space this time? Usually you guys just give us one color of
flags used to stake the area.
Please advise,
Thanks,
Judith
From: Tokar, Mark
Sent: Wednesday, November 23, 2011 8:17 AM
To: LaCosse, Judith; Ortega, Marco
Cc: Wells, Alexis; Gilmore, Stephanie
Subject: RE: Full Burial Staking Request- Ruth Rodgers
1 green 1 yellow 1 pink 1 orange flag.
From: LaCosse,Judith
Sent:Tuesday, November 22, 2011 11:06 AM
1
To: Ortega, Marco
Cc: Tokar, Mark; Wells, Alexis; Gilmore, Stephanie
Subject: Full Burial Staking Request- Ruth Rodgers
Importance: High
Hello,
We received a call from David C.Gross Funeral Home for a full burial staking request for:
Full burial: Ruth Rodgers, Block 14, Lot 558,Space 2 (she passed away yesterday, November 21st)
Burials nearby:
Space 1= Isaac G. Rodgers—(her husband)—full burial
Space 3=James A. Faris—full burial
Space 4= Phyllis H. Faris—full burial
(see attached print out)
<< File: Block 14, Lot 558.pdf»
Staking is needed by next Monday, November 28th at 11:00 a.m.
Please advise as soon as you can the color of the flags being used so that we could notify the funeral home.
Thanks for your help.
Judith LaCosse
Staff Asst.
City o f Clearwater
Official Records&Legislative Services
727-562-4093
2
ATTN: Michael Gross (a7 David C. Gross Funeral Home
Fax: 727-341-2220
This fax includes a map of the Clearwater Municipal Cemetery (3 sheets).
Deceased: Ruth Rodgers
Gravesite: Block 14 / Lot 558 / Space 2
Gravesite has been flagged with 1 green, 1 yellow 1 pink & 1 orange flaq by our
Parks and Recreation Dept.
Full burial to take place Monday, November 28th at 11:00 a.m.
Burials nearby:
Space 1 = Isaac G Rodgers — Full burial
Space 3 = James A Faris — Full burial
Space 4 = Phyllis H Faris — Full burial
Staking Fee: $30.00
Please make check payable to: City of Clearwater
Mail to: City of Clearwater
Official Records Dept.
112 S. Osceola Avenue
Clearwater, FL 33756
Attn: Judith LaCosse
Please contact me with any questions.
Thank you,
Judith LaCosse
Staff Assistant
Official Records & Legislative Services
727-562-4093
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DAVID C. GROSS FUNERAL HOMES g
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63-466/631
6366 Central Avenue ,,
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DETACH AND RETAIN THIS STATEMENT
THE ATTACHED CHECK IS IN PAYMENT OF ITEMS DESCRIBED BELOW.IF NOT CORRECT PLEASE NOTIFY US PROMPTLY NO RECEIPT DESIRED.
Eternal Light Funeral Care,Inc.
DATE ACCOUNT DESCRIPTION AMOUNT
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