Rhodes, John S. IIIDate: / a-017
Cemetery Call Work Sheet
Funeral Home / Monument Company: VifrkSoh FL4 -Ho h. 2.
Contact Name: Tel. #:-4-7- f 1( Fax #:
Reason for call: Staking Request (Interment/Disinterment)
Affidavit (Burial Rights)
V. Monument (Marker) being
� plS�k (No fee for staking of monument)
aced
For:
Block Lot -7 Space I (1- 2-
Date: / / Time:
A SAP
(Send email to P &R) t/
Verifying Burial space
Other reason:
3 Qwe fe4 .. out.e
Obukk , •. Joilh 5. L es
Interment: (One full burial and one urn, or two urns per space)
Full 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
•
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Cemetery Tracking System - View Lot Profile
Block: 12 Lot: 7
Click 'View Assigned' to view interment details. If more than one individual is interred in a space, a
second grid will appear below, displaying all of the individuals assigned to the space. Click 'View' on the
second grid to view the interment details of that individual.
Profile Summary
You are logged in as )udith.LaCosse
'EAST SIDE OF MYRTLE AVENUE
Space Owner Last Owner First Owner Middle Max Interred Total Assigned Interred
BROWNE
DONALD
S
2
0 View Assigned
S
2
0
0 View Assigned
0
0 View Assigned
4
BROWNE
DONALD
0
0
0 View Assigned
1
Updated on Tuesday, January 06, 2009
Home I Feedback I Departments I Contacts I Forms
[Too of Pane ]
LaCosse, Judith
From: Tokar, Mark
Sent: Wednesday, August 23, 2017 10:40 AM
To: LaCosse, Judith
Subject: RE: Cemetery Staking Request - Placement of a Marker
Blue flags.
From: LaCosse, Judith
Sent: Wednesday, August 23, 2017 8:46 AM
To: Tokar, Mark
Cc: Bruce, Larry; Anderson, Matthew; Vaughan, Karen
Subject: Cemetery Staking Request - Placement of a Marker
Importance: High
Mark,
I received a cemetery staking request yesterday from Lisa of Vinson Funeral Home for placement of a marker.
Please stake Block 12, Lot 7, Space 1 & 2 before the end of this week.
The funeral home will be placing a stone marker at the head between these two spaces.
If you have any questions please give me a call at 727 - 562 -4093.
Please let me know the color of the flags you will be using so that I could notify the funeral home.
Thanks.
Judith LaCosse
Staff Asst
City of Clearwater
ORLS Dept.
727 - 562 -4093
o.
•
•
4etisHED
OFFICIAL RECORDS AND
LEGISLATIVE SERVICES
October 7, 2015
Mr. John S. Rhodes III
535 Broadway
Dunedin, FL 34698
Dear Mr. Rhodes III:
CITY OF CLEARWATER
POT OFFICE Box 4748, CLEARWATER, FLORIDA 33758 -4748
CITY HALL, 112 Sovi ii Os(EOLA AVENI L, CLEARWATER, FLORIDA 33756
TELEPHONE (727) 562 -4090 FAx (727) 562 -4086
Enclosed is the Conveyance - Cemetery Lot document which indicates that you own Spaces 1
and 2 in Block 12, Lot 7 in the Clearwater Municipal Cemetery. This document has been
recorded in Pinellas County Official Records Book 18930, Page 1723.
It is important to keep this document in a safe place and to make a separate note of the
official record book and page number. We also have a copy of this document in our files.
If you have any questions please give me a call at 727 - 562 -4093.
Sincerely,
dith LaCosse
taff Assistant
Enclosures
CONVEYANCE - CEMETERY LOT
THIS INDENTURE is made this 2nd day of _September_,
2015 , between Helen V. Newsome as Grantor(s) whose mailing
address is, 2486 Belleair Road of the County of Pinellas, State of Florida ,
and John S. Rhodes Ill , 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 12 , Lot 7 , Spaces 1 & 2 Clearwater
Cemetery, as recorded in Plat Book 50 , Page _33_, 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# 2015274344 09/23/2015 at 10:16 AM
OFF REC BK: 18930 PG: 1723 -1723
DocType:DEED RECORDING: $10.00
forever.
IN WI
SS WHEREOF, said Grantor(s) have signed and sealed these presents on the day and year first above written.
(Gr tee(s name:)
(Gr for
-if'LLi)
elen V. Ne
(Grantor(s) address:)
2486 Belleair Road Clearwater, FL 33516
(Witness (2) Signed, in y presence.)
•
n S. Rho: es I l l
(Grantee(s) addresses.)
535 Broadway Dunedin, FL 34698
Pogi
STATE OF FLORIDA )
COUNTY OF PINELLAS)
Acknowledged before me on this day of — ' - . 't , 205 by31^✓'l5 "042'& ai who personally known
to me or has produced t —L- �- as identification and who did take an oath.
Public
Notary Pu
CONSENT TO CONVEYANCE
The City of Clearwater, Florida, a municipal corporation, hereby consents to the conveyance of Block
Space (5) $a-Z , 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
Ni Fyt KAREN B. VAUGHAN
MY COMMISSION # FF 046954
ti, ±_:od EXPIRES: December 20, 2017
`�Re:*. „.•'• Bonded Thru Notary Public Underwriters
12 , Lot
By:
George N. Cretekos, Mayor William B. Home, II, City Manager
oved as to form:
Robert J. S j'ttte, Assistant City Attorney
STATE OF FLORIDA)
COUNTY OF PINELLAS)
Before me personally appeared George N. Cretekos, the Mayor of the above named city, who acknow
foregoing instrument. He is personally known to me and ,dxti no ake =n oath.
WITNESS my hand and official seal this // day of 20/. .
Attest:
Rosemarie Call, City Clerk
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 11+” day of , 20 iS .
Notary Public
uted the
Notary Public State of Florida
I Patricia A Kuligowski
M Commission FF 044268
of M, xprres 10/20/2017
Notary Public
oorts Scott Burrows
a ; COMMISSION # FF164993
--,� EXPIRES: October 1, 2018
g,06r�00 �` WWW.AARONNOTARY.COM
9700 -0031
Rev. 07/2015
J S RHODES III
P0 Box 513
Clearwater, FL 33757
PAY 10 THE
ORDER OF
DATE
780
63-466/631
DOLLARS
"
REGIONS
FOR
1:063 L046681: 0062768190
Harland Clarke
OFFICIAL. RECORDS AND
LEGISLATIVE SERVICES
October 7, 2015
Mr. John S. Rhodes III
535 Broadway
Dunedin, FL 34698
Dear Mr. Rhodes III:
CITY OF CLEARWATER
POST OFFICE Box 4748, CLEARWATER, FLORIDA 33758-4748
CITY HALL, 112 SOUTH OSCEOI -\ AV ESI'E, CLEARWATER, FLORIDA 33756
TELEPHONE (727) 562 -4090 FAx (727) 562 -4086
Enclosed is the Conveyance - Cemetery Lot document which indicates that you own Spaces 1
and 2 in Block 12, Lot 7 in the Clearwater Municipal Cemetery. This document has been
recorded in Pinellas County Official Records Book 18930, Page 1723.
It is important to keep this document in a safe place and to make a separate note of the
official record book and page number. We also have a copy of this document in our files.
If you have any questions please give me a call at 727 -562 -4093.
Sincerely,
V t ,,,L . ,62,
dith LaCosse
taff Assistant
Enclosures
J S RHODES III
P 0 Box 513
Clearwater, FL 33757
PAY TO THE
ORDER OF
y-
DATE
$
REGIONS
FOR
1:06 lolal: 006 276819 780
Harland Clarke
780
63-466/631
SOCU■lly
DOLLARS n Fpaluros
DelaLls on
BaCk
^■•■
deo/ J)
CONVEYANCE - CEMETERY LOT
THIS INDENTURE is made this 2nd day of _September_,
2015 , between Helen V. Newsome as Grantor(s) whose mailing
address is, 2486 Belleair Road of the County of Pinellas, State of Florida ,
and John S. Rhodes Ill , 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 12 , Lot 7 , Spaces 1 & 2 Clearwater
Cemetery, as recorded in Plat Book 50 , Page _33_, 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
forever.
IN WI
(Gr for
elen V. Ne
KEN BURKE, CLERK OF COURT
AND COMPTROLLER PINELLAS COUNTY, FL
INST# 2015274344 09/23/2015 at 10:16 AM
OFF REC BK: 18930 PG: 1723 -1723
DocType:DEED RECORDING: $10.00
behoof of the said Grantee(s) and heirs and assigns
SS WHEREOF, said Grantor(s) have signed and sealed these presents on the day and year first above written.
(Gr,; tee(s) name:)
(Grantor(s) address:)
2486 Belleair Road Clearwater, FL 33516
(Witness (2) Signed, in/ y presence:)
(Grantee(s) addresses:)
535 Broadway Dunedin, FL 34698
STATE OF FLORIDA )
COUNTY OF PINELLAS) mot
Acknowledged before me on this ' day of I`%� t , 2011, by:3 k -"""d2•S• � who personally known
to me or has produced 1—L .L
KAREN B. VAUGHAN
MY COMMISSION # FF 046954
j EXPIRES: December 20, 2017
f
�� ar �;••` Bonded Thai Notary Public Underwriters
as identification and who did take an oath.
Notary Public
CONSENT TO CONVEYANCE
The City of Clearwater, Florida, a municipal corporation, hereby consents to the conveyance of Block 12 , Lot
Space (S) $ a- 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
— e -o(ncr t tco,s
By (,u,;.�CXR1I/■ f gL.1.u.Q..14,
George N. Cretekos, Mayor William B. Home, II, City Manager
oved as to form:
JA
•
Robert J. S
tte, Assistant City Attorney
STATE OF FLORIDA)
COUNTY OF PINELLAS)
Before me personally appeared George N. Cretekos, the Mayor of the above named city, who acknow
foregoing instrument. He is personally known to me and,dtd noyfake n oath.
WITNESS my hand and official seal this // day of 7`P✓ 20/. .
Attest:
/1'L.r (A- ct--et_
Rosemarie Call, City Clerk
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 (N^ day of , 20 S .
uted the
Notary Public State of Florida
. r Patricia A Kuligowski
M Commission FF 044268
spires 10/20/2017
Notary Public
Notary Public
6)-
Scott Burrows
COMMISSION I FF164993
EXPIRES: October 1, 2018
WWW.AARONNOTARY.COM
9700 -0031
Rev. 07/2015
Itt
OFFICIAL RECORDS AND
I,ECISI.ATI E SERVICES
September 9, 2015
Mr. John S. Rhodes III
535 Broadway
Dunedin, FL 34698
Dear Mr. Rhodes III:
CITY OF CLEARWATER
POST OFFICE Box 4748, CLEARWATER, FLORIDA 33758 -4748
Gin HAI.1., 112 Soi iii OSCEOLA AS ENI'E, CLEARWATER, FLORIDA 33756
TELEPHONE (727) 562 -4090 FAX (727) 562 -4086
This letter is to inform you that we recently provided you with incorrect information in
regards to the actual fees for the consent to transfer ownership of burial plots at the
Clearwater Municipal Cemetery. The fees associated with this transaction are:
$25.00 — (Transfer fee)
$10.00 — (Recording fee)
Total cost is $35.00.
You have already paid $18.50 so we will need another check for the balance of $16.50.
When we receive your payment, the consent of conveyance - cemetery lot document will be
sent to the Pinellas County Clerk of the Circuit Court for recording.
We will then update our cemetery program to reflect your name as the new owner and mail
you the original recorded document.
Enclosed is a self addressed /stamped envelope for your convenience.
We apologize for the inconvenience. If you have any questions please give me a call at 727-
562 -4093.
Sincerely,
dith LaCosse
Staff Assistant
Enclosure
Elk