Raspa, EvelynCemetery Call Work Sheet
Date: I° / 1'i / ,�.oi`t
Funeral Home / Monument Company: 04o61,-ems
Contact Name: ob Gr &''t Tel. #:-7,1-7-1 ifla -305!)--- Fax #: t 3-0.9-53
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
Owner of Plot:
Deceased Name: Ve4Q� 4 l e-L.1 •
Block 15 Lot r75- Space 3
Date of Birth: g / 1C1 /
Date of Burial: /0 / 3° / )- °/'t
Date of Death ' / / 1
Time:
II :000
p
$30.00 Staking Fee (Funeral Home) — received on: I`) / / a°It
Pen►r.;ct- 4 14-1.3
Copy of permit emailed to Mar-co co Ofteeja, ec: Mark Tokar /P &R on: 10 / 31 / (1 `
******************************************************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** c c a 1
Disinterment:
3a• too
The following authorization should be obtained prior to disinterment: A-t fr�
1.) A disinterment permit and burial /cremation transit permit )3?.) 6 r ..v,-1- 1
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
Status of Block: 15 Lot: 75 as of 10/14/2014
1
INTERMENTS:
SPACE BURIALTYPE DECL DECF DECM BIRTH DEATH INTERRED PERMIT
1 FULL BARABAS WILLIAM P 1/1/1919 12 / 31 / 1975 12/31/1975 1125
2 FULL RASPA WILLIAM 9/15/1915 12 / 30 / 1994 1/3/1995 1220
4 FULL JAMES JOSEPH 1/23/1928 01 / 26 / 1994 2/5/1994 2138
DISINTERMENTS FROM SPACE:
No Matching Records
REINTERMENTS:
No Matching Records
Page 1 of 1
LaCosse, Judith
From:
Sent:
To:
Subject:
Red flags
Tokar, Mark
Wednesday, October 15, 2014 8:32 AM
LaCosse, Judith
RE: Cemetery Staking - Urn burial
From: LaCosse, Judith
Sent: Tuesday, October 14, 2014 3:20 PM
To: Tokar, Mark
Cc: Sarnoff, Cherise; Wells, Alexis; Gilmore, Stephanie; Vaughan, Karen
Subject: Cemetery Staking - Urn burial
Importance: High
We received a staking request from Bob Grant of Rhodes Funeral Home for an Urn burial for:
Evelyn Raspa in Block 15, Lot 75, Space 3 DOB: 8/19/19 — DOD: 8/24/14
Other burials nearby in this plot:
Space 1= William P Barabas - (full)
Space 2 = William Raspa - (full)
Space 4 = Joseph James - (full)
Staking is needed by Thursday. October 30th at 11:00 a.m.
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
October 15, 2014
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: Evelyn Raspa
Gravesite: Block 15, Lot 75, Space 3
Urn Space
Gravesite flagged with Red flags.
Nearby Burials:
Space 1 = William P Barabas — (full)
Space 2 = William Raspa — (full)
Space 4 = Joseph James — (full)
Please contact me with any questions.
Thank you,
Judith LaCosse
Official Records & Legislative Services
City of Clearwater
727 - 562 -4093
THE/ DONNA M RASPA
Cgofcfen Circle 363 KELLY MOUNTAIN RD.
BREVARD, NC 28712
PAY TO
TFIF ORI)
66- 7704/2531
DATE 9 —d171—/
$ 3v • (/i?
1921
DOLLARS u
State Em
10 ees' Credit Union®
Brevard, North Carolina
94
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