Thornton, Jeanne B Cemetery Call Work Sheet
Date: / I'f / a-
Funeral Home / Monument Company: ("io cs Fe-ad-Q.1 .
Contact Name: R°11 h
Tel. #: 1 ?- Sc - Fax #: 1a )- 515-- lSya-
Reason for call: ✓ 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 Urn Space
Owner of Plot: Jam R • 13.0-4
Deceased Name: j-ea."ke C3• 7 k or"t°"'
hA;Lk ILO-C)
Block I Lot I'1 Space 1
Date of Birth: / a4- / I°(4.g Date of Death / 021 / 01°11
b wok
Date of Burial: 3 / a-Lt / a°(a Time: 0°°" am/O M c"1" 9f-Iv
$30.00 Staking Fee (Funeral Home) - received on: 3 / /
Copy of permit emailed to Mark Tokar, Marco Ortega/P&R 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
Revised 10/28/11
1
Status of Block: 1 Lot: 14 as of 03/14/2012
1
INTERMENTS:
SPACE BURIALTYPE DECL DECF DECM BIRTH DEATH INTERRED PERMIT •
1 URN THORNTON JEAN B 1/1/1901 0
2 FULL THORNTON MAX C 5/6/1926 05/13/2008 7/22/2008 2589
3 FULL THORNTON DARYL D 1/1/1901 0
4 FULL THORNTON GRANT B 0
6 FULL COLEMAN RICHARD A 4/3/1855 02/16/1907 2/16/1907 0
9 FULL BLOUNT SUSANNE
1/1/1901 10/01/1895
10/1/1895 1257
10 FULL BLOUNT JAMES R 1/1/1901 0
12 FULL THORNTON,JR. MAX C 0
13 FULL UNKNOWN 1/1/1901 01/01/1901 1/1/1901 0
DISINTERMENTS FROM SPACE:
No Matching Records
REINTERMENTS:
No Matching Records
Page 1 of 1
P
• • ' Cemetery Call Work Sheet
Date: 7 / /3 / .1011
Funeral Home / Monument Company: MOSS FA -(t-- - Se-rev + GS1e4,5
Contact Name: Po
Tel. #: Sot 5- 1 Fax#:
Reason for call: Staking Request (Interment/Disinterment)
Affidavit (Burial Rights)
Monument (Marker) being placed (No fee for staking of monument)
Verifying Burial space
Other reason: -11'--" - • f•i Je a.1 Tai,or•,-c or%
a Ket hew .
**************************************************************************************************
Interment: (One full burial and one urn, or two urns per space)
Full Burial Urn Space
Owner of Plot: P.• +d^'b
Deceased Name: c e_e4.4. R • T40r-A.6°ON. ) (13 41
Block I Lot ('f Space I (Al s '`K ()A.A.
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 Abe permitted to authorize burial
� 13- �,.,,w„1 ?113 4,1 6 01.-teat hti�h l L11 9-
Revised 6/29/11 p�
4" �
SEE SHEET I
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97 92 83 78 67 62 51 46 35 30 19 14 3
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487 359 231 2
379 251 123 I10
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383 255 127 106
481 353 225 8
385 257 129 104
479 351 223 10
387 259 131 102
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475 347 219 14 S
391 263 155 98
473 345 217 16
393 265 137 96
471 343 215 18
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399 271 143 90
465 337 209 24 Z
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W 461 333 205 28
O 405 277 149 84
(1) N 1 459 331 203 __ 30
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457 329 201 32
409 281 153 80
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W 411 283 155 78
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423 295 167 66
441 313 185 48
425 297 169 64
439 311 183 50
427 299 171 62
O 437 309 181 52
O 429 301 173 60
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435 _307 179 54
431 303 175 58
433 305 177 56
CLEARWATER CEMETERY
Dwg. No. 9039-3
Sheet 3 of 3
LaCosse, Judith
From: Ortega, Marco
Sent: Thursday, March 15, 2012 10:44 AM
To: LaCosse, Judith
Cc: Tokar, Mark; Wells, Alexis
Subject: Re: Cemetery Staking Request- Urn burial
All set green -Flags.
Regards,
Marco
On Mar 14, 2012, at 11:09 AM, "LaCosse, Judith" <Judith.LaCosse @myClearwater.com> wrote:
> Hi Marco,
> We received a call this morning -From Robin at Moss Feaster requesting a staking for an Urn
burial -For:
> Jeanne B. Thornton in Block 1, Lot 14, Space 1 - DOB - 11/24/28 - DOD 6/21/11
> (See attached status sheet regarding burials in this block and lot)
> Staking is needed by next week sometime, actual urn interment is not until Saturday, March
24th at around Noon.
> Please advise me with the color of the flags being used so that we could notify the funeral
home.
> Thanks for your help.
> Judith LaCosse
> Staff Assistant
> Official Records and
1
•
> Legislative Services Dept.
> 727-562-4093
> <Block 1 Lot 14 Sp 1.pdf>
2
•
March 15, 2012
Attn: Robin
Funeral Home: Moss Feaster/Largo
Fax: 727-595-1592
Deceased: Jeanne B. Thornton
Gravesite: Block 1, Lot 14, Space 1
Urn Space
Gravesite flagged with Green flags.
Date of burial: 3/24/2012 - Noon
Nearby Burials:
Space 2 = Max C Thornton — Full burial
Space 3 = Daryl D Thornton — Full burial
Space 4 = Grant B Thornton — Full burial
Staking Fee: $30.00
Please make check payable to: City of Clearwater
Mail to: City of Clearwater
Official Records Dept. — 2nd Floor
112 S. Osceola Ave.
Clearwater, FL 33756
Please contact me with any questions.
Thank you,
Judith LaCosse
Official Records & Legislative Services
City of Clearwater
727-562-4093
•
Vendor CITY OF CLEARWATER 03/22/2012
Vendor No. 3141616 Amount *""""$30.00 10694649
PAYMENT DETAILS
staking fee/Thornton/01003447
•
THE FACE OF THIS CHECK IS PRINTED BLUE-THE BACK CONTAINS A SIMULATED WATERMARK
Garden Sanctuary Funeral Home Amegy Bank N.A.
7950 131 Street North 35-1125 '10694649
Seminole, FL 33776 Porter,TX 1130
03/22/201'2
PAY Thirty and 00/100 Dollars
6 48
ao n o
***********$3000
PAY TO THE :CITY OF CLEARWATER
ORDER OF 112 S OSCEOLA AVE
CLEARWATER, FL 33756
Memo: , staking fee/Thornton/01003447 /0/
II■ L06946490 1: L L 3 L L 0 5 8 6 1: 4 4 4 40 70 7 211'
�,,,,$ : N2 445282
er' �;, CITY OF CLEARWATER, FLORIDA
= 41 MISCELLANEOUS RECEIPT
Date 114^-e-L , 20 !49.'4
oros
Received from lSCirete.il S4r c " t'u► 4 }Iov /11 oSs Fec
In payment of Gta knit ' ..¢-t. - (Jeahn.e. a. Thorrt'ron
�c�
Amount received �►i r� ant A0 0
Dollars
Fund Code O/n 3t-3 got
CITY OF CLEARWATER
$ .30,0° * wocict -r9 “4+1..
Department —0 g.LS Receiv-. :y