Ponds, Otis Jr.Cemetery CaII Work Sheet
Date: 3 / 9 / 16
Funeral Home / Monument Company: I\cSS Fc.4te,x _ Ric C - -Ce..Q : S-(oa -ao -10
51 a- ao
Contact Name: O'h5 Tel. #: 7a7- `f3‘t-1ir- °Fax #:
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:
ohs bAvj Poit6,
Block lo, Lot c2't, SD. 9 (fa)
l -r. iS Pov+.d4) J . Czte_,il A a<
nit.Qoc i 4 eon S bcoi ect poh.A/ +, Klor � Flo r:d2&.
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** R * * * * * v., * * +0 ** *ss * *�?? * * * * *` CLeA-)
Interment: (One full burial and one urn, or two urns per space)
Full Burial
Owner of Plot:
Deceased Name:
Urn Space
Block Lot Space
Date of Birth: / / Date of Death / /
Date of Burial: / /
Time: am /pm
$30.00 Staking Fee (Funeral Home) — received on: / /
Copy of permit emailed to Mark Tokar, cc: Cherise Sarnoff /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 11/24/14
': Main Report Nsi
INFORMATION REPORT FOR: BLOCK: 10 LOT: 24 SPACE: 9
CURRENT OWNER:
OWNER 1:
OWNER UNKNOWN
SPACE TYPE:
CURRENT SALES INFORMATION:
None
PREINTERMENT INFORMATION:
None
INTERMENT INFORMATION:
DECEASED: OTIS D PONDS
INTERRED: 7/1/1958 :
BIRTH: 1/1/1958
DIRECTOR:
NOTES: None
DEATH: 7/1/1958
4 ! N 1/2
OWNER 2:
OTIS D. PONDS,
INTERRED
RELATION to OWNER l:
RIGHTS:
BURIALTYPE: FULL
PROCESSED: 5/18/2011
PERMIT#: 0
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Good Morning! Today is Tuesday, March 10, 2015
Cemetery Tracking System - Interment Detail
Block: 10 Lot: 24 Space: 9
Rights Granted:
Burial Type:
First Name:
Date of Birth:
Interment Date:
Interment Director:
Staking Fee $
Interment Notes:
?
FULL
OTIS
01/01/1958
07/01/1958
MI:
D
0
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You are logged in as Judith.LaCosse
Interment Processed:
05/18/2011
Owner of Space?
Last Name:
Date of Death:
Time of Service:
Permit:
Date Paid:
YES
PONDS
07/01/1958
0
Updated on Tuesday, January 06, 2009
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I1 / 1 Main Report
Status of Block: 10 Lot: 24 as of 03/10/2015
INTERMENTS:
SPACE BURIALTYPE DECL DECF DECM BIRTH DEATH INTERRED
1 INFANT CURL SHARON L 1/1/1954 04 / 05 / 1956 4/5/1956
4 INFANT ALKINS INFANT 8/20/1956 08/20/1956 8/20/1956
8 URN CURL ALVIN C 11/20/1930 11 / 08 / 1982 11/16/1982
9 FULL PONDS OTIS D 1/1/1958 07 / 01 / 1958 7/1/1958
11 INFANT FAULKNER UNKNOWN 1/1/1901 06/ 19/ 1958 6/25/1958
DISINTERMENTS FROM SPACE:
No Matching Records
REINTERMENTS:
No Matching Records
N: 1/1
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LaCosse, Judith
From: Tokar, Mark
Sent: Friday, March 13, 2015 8:26 AM
To: LaCosse, Judith
Subject: RE: Cemetery Staking Request
Yellow flags.
From: LaCosse, Judith
Sent: Wednesday, March 11, 2015 3:21 PM
To: Tokar, Mark
Cc: Wells, Alexis; Sarnoff, Cherise; Vaughan, Karen
Subject: Cemetery Staking Request
Importance: High
We just received another staking request from Rick Chesler of Moss Feaster. Mr. Chesler is working with the father of
the deceased, Otis Ponds Jr.
Name of deceased: Otis David Ponds, III
Please Stake Space 9 of Block 10, Lot 24
Other burials nearby in this plot:
Space 8 = Alvin C Curl — Urn burial
Space 10 = Vacant
Space 11 = Infant (Faulkner)
Please advise me of the color of flags being used so that I could notify Mr. Chesler.
Thank you.
Judith LaCosse
Staff Asst
City of Clearwater
ORLS Dept.
727 - 562 -4093
1