Hutchinson, ClaudiaDate: 7 / / /
Funeral Home; Monument
Contact Name: l%Q�
Reason for call:
Cemetery Call Work Sheet
CIompany:
tttc.k.1 n5 ��►�Tel. #:35 t,R6Fax #:
Staking Request (Interment/Disinterment) A�
W F1 revl.c e Pt • (v g..11 S vvl (CkAkn \ st, J
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Affidavit (Burial Rights)
Monument (Marker) being placed
For:
Block Lot Space
Date: / / Time:
(No fee for staking of monument)
Sp46e. = Pt A e w`' 45-
(Send email to P &R)
Verifying Burial space co r't iilCCoy J FL 3 /3i
4:/ Other reason: (C-0(A-4-7 r M4r /
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* 15,9-30 N c— 15-0 Nc(c e.
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************************ * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** * * * * * * * * * * * * * * * * * * ** ** * * * * * * * * * * **
S• I '
Mi
Interment: (One full burial and one urn, or two urns per space)
FuII Burial Urn Space
Owner of Plot:
Deceased Name:
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
AFFIDAVIT
STATE OF FLORIDA)
COUNTY OF PINELLAS)
I, Claudia Hutchinson, the undersigned, do hereby attest that I am the
descendant of Florence M. Nelson (Carlson), my mother, owner of Spaces 1 & 2 of
Block 9, Lot 106 in the Clearwater Municipal Cemetery. Andrew Carlson is buried in
Space 1 and Space 2 is currently vacant. My mother is buried out of state.
Please take this affidavit as your authority to note the right to property described
above to myself. Per the City of Clearwater Rules and Restrictions the maximum
capacity of a space is two burials provided at least one person is cremated or two
cremated remains.
I agree to release, indemnify and hold the City of Clearwater harmless from
liability in the event of any claim arising from the use of the above described property as
stated above.
SIGNATURE ADDRESS /PHONE
CIa dia Hutchinson
15230 NE 150 Place
Fort McCoy, FL 32134
—f G1
SWORN TO and subscribed before me this I day of
2 01 by Claudia Hutchinson who produ I ntification in
FlO/06T �Rr�Caots CtLe4se_ and who di ke a• oath.
DOROTA WASILEWSKA
I' COMMISSION 8 EE 830049
EXPIRES: August 23, 2016
Bonded Thru Notary Pubic Underwriters
rn? O
Notary Public
My commission expires:
Status of Block: 9 Lot: 106 as of 08/10/2015
INTERMENTS:
SPACE BURIALTYPE DECL DECF DECM BIRTH DEATH INTERRED PERMIT
1 FULL CARLSON ANDREW A 1/1/1918 01 / 01 / 1946 1/1/1946 0
3 FULL JEFFREY LENA H 1/1/1885 01 / 01 / 1948 1/1/1948 0
4 FULL KIRK MAMIE E 1/1/1882 01 / 01 / 1946 1/1/1946 0
DISINTERMENTS FROM SPACE:
No Matching Records
REINTERMENTS:
No Matching Records
Page 1 of 1
LaCosse, Judith
From: LaCosse, Judith
Sent: Thursday, August 13, 2015 11:08 AM
To: 'CLAUDIA HUTCHINSON'
Subject: RE: Appointment 8/24 2:30 pm
Importance: High
Hi Claudia,
Monday, August 24th would be good.
We need the completed /signed conveyance- cemetery lot document.
And, we also require a check from the buyer for $35.00 made out to the City of Clearwater for
the transfer fee ($25.00) and the recording fee ($10.00).
I will see you soon !!
Thank you.
Judith LaCosse
Staff Asst
City of Clearwater
ORLS Dept.
727 - 562 -4093
Original Message
From: CLAUDIA HUTCHINSON [ mailto: hutchinsonc23Pcenturylink.net]
Sent: Thursday, August 13, 2015 10:23 AM
To: LaCosse, Judith
Subject: Appointment 8/24 2:30 pm
Hi Judith
I have a buyer for that cemetery space. Could we and the buyer meet with you on Monday 8/24
around 2 or 2:30 pm to complete transfer?
thanks
Claudian Hutchinson
1
CONVEYANCE-CEMETERY LOT
THIS INDENTURE is made this) I ' day of 9 LA. , 20 t
between Claudia Hutchinson , as Grantor(s) whose mailing
address is, 15230 NE 150 Place, Fort McCoy, FL 32134 of the County
of Marion , State of Florida , and Vincent Saporito
as Grantee(s):
WITNESSETH: That the said Grantor(s) transfer ownership to Grantee(s)
and has remised, released and quit claimed unto the said Grantee(s), and heirs
forever, all the right, title and interest which the said Grantor(s) have in and to the
following described parcel of land, lying and being in Pinellas County, State of
Florida, to wit: Block 9 , Lot 106 , Space 2 Clearwater
Cemetery, as recorded in Plat Book 60 , Page 30 , Public Records of Pinellas
County, Florida.
This Conveyance is subject to the condition that Grantee(s) herein shall
not assign or convey said property without the written consent of the City of
Clearwater, Florida and to the further condition that said property shall be used only for cemetery purposes as human burial sites, and is
subject to such other regulations the City of Clearwater may adopt pertaining to use of said property.
TO HAVE AND TO HOLD the same to the only proper use, benefit, and behoof of the said Grantee(s) and heirs and assigns
KEN BURKE, CLERK OF COURT
AND COMPTROLLER PINELLAS COUNTY, FL
INST# 2015253165 09/03/2015 at 09:42 AM BK: 18909 PG: 261-261
OFF ype
DocTyp DEED RECORDING: $10.00
forever.
/ n IN WITNESS WHEREOF, said Grantor(s) have signed and sealed these presents on the day and year first above written.
(Gra for name) ,/, (Grantee name) _
0
Claudia Hutchinson Vincent Saporito `' �
(Grantor address)
15230 NE 150 Place, Fort McCoy, FL 32134
(Witness (2) Signed in my presence)
STATE OF FLORIDA )
COUNTY OF PINELLAS)
(Grantee address)
2010 McKinley St., Clearwater, FL 33765 -2534
Acknowledged before me on this 4 day of ► '71 3.:-S"
to me or has produced P L L'
�Y
KAREN B. VAUGHAN
ifr.. ry ;
,., ,.__ MY COMMISSION # FF 046954
i i
:, � 41 EXPIRES: December 20, 2017 �
%, p f tAc
Bonded Thru Notary Public Underwriters
)4,a2
20I byC2-1CL.kc C:. Hu-t
as identification and who did take an oath.
Notary Public
who personally known
CONSENT TO CONVEYANCE
The City of Clearwater, Florida, a municipal corporation, hereby consents to the conveyance of Block 9 , Lot 106
Space 2 , Clearwater Cemetery, from the Grantor(s), to the Grantee(s).
IN WITNESS WHEREOF, said Grantor has caused these presents to be executed in its name by its Mayor, by its City Manager,
and to be attested and its corporate seal affixed by the City Clerk on the day and year first above written.
Countersigned: CITY OF CLEARWATER, FLORIDA
- geOrtie^CtC./eV.°
George N. Cretekos, Mayor
Apprpve �s toform:
R�Q.obert J.
Sur ur�tte/%ssistant City Attorney
.�✓' STATE OF FLORIDA )
COUNTY OF PINELLAS)
By:
tY1/4-A4, eb idA444127a.
William B. Home, II, City Manager
Attest:
(2a
Rosemarie Call, City Clerk
Before me personally appeared George N. Cretekos, the Mayor of the above named
foregoing instrument. He is personally known to me and di not take an oath.
WITNESS m y hand and officialA� s , f'h .,*� .� , 201S.
� XR
. o's
itterA
STATE OF FLORIDA )
COUNTY OF PINELLAS)
Before me personally appeared William B. Home, II, the City Manager of the above -named city, who acknowledged that he executed
the foregoing instrument. He is personally known to me and did not take an oath.
WITNESS my hand and official seal this S' -day of Arc j S ar , 20 1J'
COMMISSION #` FF164993
EXPIRES: October 1, 2018
WWW.AARONNOTARY.COM
city, who acknowledge • - executed the
O
1ARV SANDRA HARRIGER
, NOTARY PUBLIC
STATE OF FLORIDA
Comm# EE142238
Expires 1/4/2016
Notary Public
9700 -0031
Rev. 07/2015
OFFICIAL RECORDS AND
LLGISLvIIvE SERVICES
September 11, 2015
CITY OF CLEARWATER
Mr. Vincent Saporito
2010 McKinley St.
Clearwater, FL 33765 -2534
POST OFFICE Box 4748, CLEAR \\ATER, FLORIDA 33758 -4748
CIT1 HALL, 1 12 So TI I OSCEOLA AV ENI'E, CLEARWATER, FLORIDA 33756
TELEPHONE (727) 562-4090 FAX (727) 562-4086
Re: City of Clearwater Municipal Cemetery
Block 9, Lot 106, Space 2
Dear Mr. Saporito:
Enclosed please find the original recorded Conveyance - Cemetery Lot document which was
recorded with Pinellas County Clerk of the Circuit Court on September 3, 2015. This
document transfers ownership of Space 2 in Block 9, Lot 106 in the City of Clearwater
Municipal Cemetery to you from the seller, Ms. Claudia Hutchinson.
Our Cemetery program and files have been updated to reflect that you're the current owner
of Space 2 in Block 9, Lot 106.
If you have any questions, please give me a call at 727 - 562 -4093.
Sincerely,
dith LaCosse
taff Assistant
Enclosure
+'slgeU %%
OFFICIAL. RECORDS ANI)
LEGISLATIVE SERVICES
September 11, 2015
Ms. Claudia Hutchinson
15230 NE 150 Place
Fort McCoy, FL 32134
CITY OF CLEARWATER
POST OFFICE Box 4748, CLEARWATER, FLORIDA 33758-4748
CITY HALL, 112 SourN OSCEOLA AVENUE, CLEARWATER, FLORIDA 33756
TELEPHONE (727) 562 -4090 FAx (727) 562 -4086
Re: City of Clearwater Municipal Cemetery
Block 9, Lot 106, Space 2
Dear Ms. Hutchinson:
Enclosed please find a copy of the recorded Conveyance - Cemetery Lot document which
was recorded with Pinellas County Clerk of the Circuit Court on September 3, 2015. This
document transfers ownership of Space 2 in Block 9, Lot 106 in the City of Clearwater
Municipal Cemetery to Mr. Vincent Saporito.
Our Cemetery program and files have been updated to reflect new ownership by Mr.
Saporito.
If you have any questions, please give me a call at 727 - 562 -4093.
Sincerely,
dith LaCosse
Staff Assistant
Enclosure
tr