Falzoni, Victoria Cemetery Call Work Sheet
Date: ` / 11 / 301a
Funeral Home / Monument Company:
Contact Name: Bo° G‘rcc.p,-t Tel. #: 055- Fax #: 4-16 - °a 5-3
Reason for call: Staking Request (Interment/Disinterment)
Affidavit (Burial Rights)
Monument (Marker) being placed (No fee for staking of monument)
For:
Block Lot Space
Date: / / Time:
(Send email to P&R)
Verifying Burial space
Other reason:
Interment: (One full burial and one urn, or two urns per space)
Full Burial Urn Space 1Z/ 4 i a _
Jvi.Sek 6-u
Owner of Plot: v+4.40r'n F- 2v��� cQ L)/ 0t-a-P1a-t
Deceased Name: V/+ (-- 0 r I " & /z o f4A
Block 15 Lot ci a- Space a--/
Date of Birth: 1° / )-(t/ (9d�j Date of Death Ia / 1�/ I (�a
N o Zvi cc
Date of Burial: 1 / 25 / a 013 Time:
Staking Fee (Funeral Home) — received on: I / (,,14/ 13
Copy of permit emailed to Marco Ortega, cc: Mark Tokar/P&R on: / / 3 00
**************************************************************************************************
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 10/31/12
f
-, Status of Block: 15 Lot: 92 as of 12/19/2012
INTERMENTS:
SPACE BURIALTYPE DECL DECF DECM BIRTH DEATH INTERRED PERMIT
1 URN FALZONI JAMES 1/13/1962 12/07/2006 12/18/2006 2574
1 FULL FALZONI CARL F 8/22/1927 07/31/1995 8/10/1995 2226
3 URN FALZONI PETER 3/15/1952 06/28/2008 7/9/2008 2587
4 FULL GREEN LOUIS 10/13/1947 11/03/1994 11/8/1994 2185
DISINTERMENTS FROM SPACE:
No Matching Records
REINTERMENTS:
No Matching Records
Page 1 of 1
LaCosse, Judith
From: LaCosse, Judith
Sent: Tuesday, January 22, 2013 2:41 PM
To: Ortega, Marco
Cc: Tokar, Mark; Wells, Alexis; Gilmore, Stephanie; Vaughan, Karen
Subject: RE: Cemetery Staking - Urn burial
Thank you. I will notify the funeral home.
From: Ortega, Marco
Sent: Tuesday, January 22, 2013 2:16 PM
To: LaCosse, Judith
Cc: Ortega, Marco; Tokar, Mark; Wells, Alexis; Gilmore, Stephanie; Vaughan, Karen
Subject: Re: Cemetery Staking - Urn burial
Marked in orange.
< >wrote:
Jan 22, 2013, at 12:51 PM, "LaCosse,Judith" Jud�th.LaCosse @myClearwater.com ote•
We received a call this afternoon from Bob Grant of Rhodes Funeral Home requesting a stakin for an
Urn burial for:
Victoria Falzoni in Block 15, Lot 92,Space 2 DOB: 10/24/29—DOD: 12/15/12
Other burials nearby in this block and space:
Space 1=James Falzoni—(urn) &Carl F Falzoni—(full)
Space 3= Peter Falzoni—(urn)
Space 4= Louis Green—(full)
Staking is needed by this Friday,January 25th sometime in the morning. There will be no service.
Please advise me of the color of the flags being used so that we could notify the funeral home.
Thank You.
Judith LaCosse
Staff Assistant
Official Records and
Legislative Services Dept.
727-562-4093
1
•
January 22, 2013
Attn: Bob Grant
Funeral Home: Rhodes Funeral Home
Fax: 727-443-0253
(This fax includes a copy of Cemetery Map)
#in the circle is the Block,#in the square is the Lot
Deceased: Victoria Falzoni
Gravesite: Block 15, Lot 92, Space 2
Urn Space
Gravesite flagged with Orange flags.
Nearby Burials:
Space 1 = James Falzoni — (urn) & Carl F Falzoni — (full)
Space 3 = Peter Falzoni — (urn)
Space 4 = Louis Green — (full)
Staking fee of $30.00 was received today. Thank You.
Please contact me with any questions.
Thank you,
Judith LaCosse
Official Records & Legislative Services
City of Clearwater
727-562-4093
30783 •
WELLS FARGO BANK, N.A. 63-751-631
WORK&SON INC WELLSFARGO.COM
17705 ST LUCIA ISLE DRIVE
TAMPA,FL 33647 Dec. /17, 2011
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Tertificate of cremation
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This Certifies that the remains of e
Victoria A. Falzoni °
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Who died December 15 ,2012 , e
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Was cremated at Gee & Sorensen .
7 Crematory Services, St. Petersburg, e
Florida,on December 18 , 2012 .
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ID Tag Number: 004439 O
And these are the cremated remains of f
said deceased. 4
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Gee& Sorensen Crematory Services.
By Enoch Nicholson g
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RHODES FUNERAL DIRECTORS,INC.
800 E.DRUID ROAD i
CLEARWATER,FLORIDA 33756 JAN
121-446-3055
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