Turner, JamesCemetery Call Work Sheet
Date: / ) / a-o/5
Funeral Home / Monument Company: P kO -'-s c. H
Contact Name:
Reason for call:
re
Tel. #: 7)-7- -— 3 ( Fax #:
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
Tuul
Owner of Plot:
Deceased Name: �J << , ( `o-''`-
Block '' Lot 1 Space 11-4-
Date of Birth: S / / tit Date of Death
3 /30 / I5
Date of Burial: I / 10 / Time: I. 3° a /pm
$30.00 Staking Fee (Funeral Home) — received on: / /
Copy of permit emailed to Mark Tokar, cc: Cherise Sarnoff /P &R on:
1f , o
4 ce )'-4
S- � �t c1,4, k,
/ / (w c ' eQ )
******************************************************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
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
Status of Block: 4 Lot: 1 as of 04/07/2015
INTERMENTS:
SPACE BURIALTYPE DECL
DECF
DECM BIRTH DEATH INTERRED
PERMIT
1 INFANT UNKNOWN 1/1/1901 01 / 01 / 1901 1/1/1901 0
2 INFANT RAGER LESLIE 01 / 01 / 1927 1/1/1927 0
3 INFANT SWEET C W 01 / 01 / 1927 1/1/1927 0
4 INFANT GALLOWAY C D 01 / 01 / 1928 1/1/1928 0
5 INFANT WILLOUGHBY R G 01 / 01 / 1928 1/1/1928 0
6 INFANT WICKER HENRY 1/1/1901 01 / 01 / 1901 1/1/1901 0
7 INFANT WHITE RALPH 01 / 01 / 1928 1/1/1928 0
8 INFANT BRIDGES W L 01 / 01 / 1928 1/1/1928 0
9 INFANT SEVERANCE ERNEST P 4/28/1929 04 / 28 / 1929 4/28/1929 0
10 INFANT VAUGHAN W W 5/27/1929 05 / 27 / 1929 5/27/1929 0
11 INFANT UNKNOWN 1/1/1901 01 / 01 / 1901 1/1/1901 0
12 INFANT SUMNER RALPH E 1/14/1925 02 / 16 / 1927 2/16/1927 0
13 INFANT JEFFERSON HUBERT 1/1/1901 01 / 01 / 1901 1/1 /1901 0
14 INFANT HARRIS ALBERT 01 / 01 / 1929 1/1/1929 0
15 INFANT MCCLAMMA FLOYD G 01 / 01 / 1930 1/1/1930 0
16 INFANT WOODEN 0 W 01 / 01 / 1931 1/1/1931 0
17 INFANT GORDON HOWARD 01 / 01 / 1831 1/1/1931 0
18 INFANT WILSON J B 01 / 01 / 1932 1/1/1932 0
19 INFANT SEVERANCE E P 01 / 01 / 1932 1/1/1932 0
20 INFANT MADDOX DORIS 4/6/1932 04 / 14 / 1933 4/14/1933 0
21 INFANT SINCLAIR RALPH 01 / 01 / 1933 1/1/1933 0
22 INFANT ALCRON H T 01 / 01 / 1931 1/1/1931 0
23 INFANT ENGRAM L N 1/1/1901 01 / 01 / 1901 1/1/1931 0
24 INFANT HUGHES FLOYD 10/11/1930 10 / 11 / 1930 10/11/1930 0
25 INFANT FRYS HERBERT 01 / 01 / 1930 1/1/1930 0
26 INFANT WARE C E 01 / 01 / 1930 1/1/1930 0
27 INFANT THOMAS LUTHER J 3/9/1931 04/06/1931 4/6/1931 N
28 INFANT BRYSON H S 01 / 01 / 1933 1/1/1933 0
29 INFANT WILLIAMS 0 M 01 / 01 / 1932 1/1/1932 0
Page 1 of 2
INTERMENTS:
SPACE BURIALTYPE DECL DECF DECM BIRTH DEATH INTERRED PERMIT
30 INFANT CHENNEY N/A 7/26/1931 07 / 26 / 1931 7/26/1931 0
31 INFANT BARLOW J H 01 / 01 / 1934 1/1/1934 0
32 INFANT PEED 0 M 01 / 01 / 1934 1/1/1934 0
39 FULL TURNER, SR JOSEPH K 11/24/1907 11 / 04 / 1990 11/7/1990 1924
40 FULL TURNER LAURA W 3/5/1910 10 / 02 / 1993 10/5/1993 2120
DISINTERMENTS FROM SPACE:
No Matching Records
REINTERMENTS:
No Matching Records
Page 2 of 2
H_ 4 - V C 4 v‘.1-
f
Status of Block: 4 Lot: 28 as of 04/09/2015
1
INTERMENTS:
SPACE BURIALTYPE DECL
DECF DECM BIRTH DEATH INTERRED PERMIT
1 FULL TURNER ARTHUR C 2/26/1844 08 / 09 / 1929 8/9/1929 0
2 INFANT TURNER JESSE K 4/21/1896 04 / 21 / 1896 4/21/1896 0
3 FULL TURNER LILLIAN E 11/24/1853 04 / 21 / 1896 4/21/1896 0
4 FULL TURNER KEZIAH F 2/17/1850 12 / 26 / 1885 12/26/1885 0
5 INFANT TURNER KEZIAH F 12/25/1885 09 / 08 / 1886 9/8/1886 0
6 INFANT TURNER EDGAR K 12/25/1885 09 / 09 / 1886 9/9/1886 0
6 INFANT CRANE ROBERT B 8/27/1890 10 / 22 / 1890 10/22/1890 0
7 INFANT TURNER GEORGE L 1/31/1900 11 / 01 / 1900 11/1/1900 0
8 FULL TURNER ANNA L 9/18/1866 12 / 18 / 1915 12/18/1915 0
9 FULL TURNER EDWARD C 6/10/1898 09 / 26 / 1918 9/26/1918 0
10 FULL TURNER ANNA V 4/24/1901 08 / 24 / 1921 8/24/1921 0
15 FULL MARTIN NINA 2/10/1914 01 / 29 / 1998 2/2/1998 2350
16 FULL MARTIN LEO F 11/25/1883 12 / 05 / 1978 12/7/1978 1283
17 FULL MARTIN LILLIAN T 8/20/1891 03 / 07 / 1980 3/10/1980 1355
18 FULL TURNER NELLIE R 12/14/1892 01 / 11 / 1978 1/14/1978 1243
19 FULL TURNER ROBERT B 7/10/1902 04 / 05 / 1974 4/8/1974 1025
20 FULL TURNER MARGARET M 8/6/1898 06 / 23 / 1976 6/26/1976 1151
DISINTERMENTS FROM SPACE:
No Matching Records
REINTERMENTS:
SPACE BURIALTYPE DECL DECF DECM DOD DOB BURIAL REINTERED PERMI'
20 FULL TURNER MARGARET M 06 / 23 / 1976 08 / 06 / 1898 06 / 26 / 1976 01 / 30 / 1998 1151
19 FULL TURNER ROBERT B 04 / 05 / 1974 07/10/1902 04 /08 /1974 01 / 30 / 1998 1025
18 FULL TURNER NELLIE R 01 / 11 / 1978 12 / 14 / 1892 01 / 14 / 1978 01 / 30 / 1998 1243
17 FULL MARTIN LILLIAN T 03 / 07 / 1980 08 /20/1891 03 /10/1980 01 / 30 / 1998 1355
16 FULL MARTIN LEO F 12 /05/1978 11 /25/1883 12 /07/1978 01 / 30 / 1998 1283
Page 1 of 1
LaCosse, Judith
From: LaCosse, Judith
Sent: Tuesday, April 07, 2015 1:16 PM
To: Tokar, Mark
Cc: Wells, Alexis; Sarnoff, Cherise; Vaughan, Karen
Subject: Cemetery Staking Request - Full burial
Importance: High
Tracking: Recipient Read
Tokar, Mark
Wells, Alexis Read: 4/7/2015 3:55 PM
Sarnoff, Cherise
Vaughan, Karen Read: 4/7/2015 1:18 PM
We received a call this afternoon from Grant of Rhodes F.H. requesting a staking for a Full burial for:
James Turner in Block 4, Lot 1, Space 44 DOB: 5/5/44 — DOD: 3/30/15
Other burials nearby in this plot:
Space 39 = Joseph K Turner Sr — (full)
Space 40 = Laura W Turner — (full)
Spaces 41 -44 = Vacant
Staking is needed by this Thursday. Date of Burial: Friday, April 10th at 1:30 p.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 Asst
City of Clearwater
ORLS Dept,
727 -562 -4093
CLEARWATER CARETAKER
CLEARWATER, FL
BURIAL PERMIT
PERMIT # 1450
May 20, 2015
Permission is hereby granted for burial of:
Name of Deceased: JAMES TURNER Burial Type: FULL
Owner of Property: TURNER &
Block : 4 Lot: 1
Date of Death: March 30, 2015
Space: 44 Date of Birth: May 5, 1944
Date of Burial: April 10, 2015
Date Paid:
Clearwater Cemetery
Funeral Home Director: GRANT /RHODES F.H.
Time: 13 :30 Staking Fee:
By
)lina
it of Health and Human Services
ecords
BURIAL- TRANSIT PERMIT
CATAWBA CO.
County
'eceased
JAMES E. TURNER
Date of Death (month, day, year)
MARCH 30, 2015
eath (Name of institution or Street Address)
25 24TH ST., NW
City
HICKORY, N.C.
County
CATAWBA
Address of Attending Physician
R. WEISGERBER_ (DAVID) 307 10TH AVE., NE HICKORY, N.C. 28601
(Name and Address)
A1FLORIDA
I Address of Funeral Home or Person Acting as such within G.S. 130A -113
FUNERAL HOME CLEARWATER, FL.
tion of Death having been filed, permission is hereby granted to
to body from this state.
of Local Registrar, Deputy Registrar or
itrar
NNT INSTRUCTIONS ON BACK Si FORM.
• (Revised 7/07)
is
Address
Date issued
APRIL 7, 2015
3(24 Ia ti4l
Funeral Director's Copy — White
Local Registrar's Copy — Pink
/AI
LZ:La 5L -0T-b0
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