Wells, Mary KayAFFIDAVIT
STATE OF FLORIDA)
COUNTY OF PINELLAS)
We, Mary Kay Wells and Barbara Anne Koontz, the undersigned, do hereby attest that
we are the descendants, survivors and heirs of Glenn H. and Ruth T. Koontz, our parents, and
Oliver and Draxie P. Snodgrass, our grandparents, owners of Block 15, Lot 5, Spaces 1-4 in the
Clearwater Municipal Cemetery. Our parents are buried in spaces 1 and 2 (urn burials) and our
grandparents are buried in spaces 3 and 4 (full burials).
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.
Please take this affidavit as your authority to note the right to property described above to
us and our spouses.
We authorize the granting of interment rights in Block 15, Lot 5, Spaces 1-4 as follows:
Space 1 = James Franklin Wells (um)
Space 2 = Mary Kay Wells (um)
Space 3 = Barbara Anne Koontz (um)
Space 4 = Etta Wadene Brenton (um)
We 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/
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Mary Kay ells
ADDRESS /PHONE
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Barbara Anne oontz
SWORN TO and subscribed before me this . 'day ofT nC 201"7 by Mary
Kay Wells who produced identification in the form of a=1, DY I vt. vS Moue. and who did / I,
not take an oath.
BAILEE ANNE BEARDEN
MY COMMISSION # FF 160933
EXPIRES: September 17, 2018
Bonded TAru Notary Pubre Undemiters
otary Public
-/ -7 - 2ViO
My commission expires:
SWORN TO and subscribed before me thisdL day o J -t , LU)1 by Barbara
Anne Koontz who produced identification in the form of and who did /did
not take an oath.
MARILEX J. RIVERA
NOTARY PUBLIC
STATE OF FLORIDA
Commit FF939742
Expires 11/30/2019
n
Notary Public
MARILEX J. RIVERA
NOTARY PUBLIC
'+STATE OF FLORIDA
C,, .e FF939742
Expi r:: 11/3012019
LaCosse, Judith
From: LaCosse, Judith
Sent: Tuesday, June 13, 2017 10:09 AM
To: 'Mary Kay Wells'
Subject: RE: Affidavit
Thank You.
Let me know if you have any other questions !!
Judith LaCosse
Staff Asst
City of Clearwater
ORLS Dept.
727 - 5624093
From: Mary Kay Wells [mailto:mkwells48 @gmail.com]
Sent: Tuesday, June 13, 2017 9:56 AM
To: LaCosse, Judith
Cc: barkoontz @aol.com
Subject: Re: Affidavit
Judy,
Thank you for the enclosed affidavit. I will print a copy, take care of our signatures /notarization and mail the
original copy to Barbara Koontz for the remaining signatures /notarization. She will then return the completed
affidavit to you ASAP.
It has been a pleasure working with you and we are very pleased with the results of all of our efforts.
Sincerely,
Mary Kay Wells
Sent from my iPad
On Jun 13, 2017, at 8:37 AM, <Judith.LaCosse @myClearwater.com> <Judith.LaCosse @myClearwater.com>
wrote:
Ms. Wells,
Attached is an affidavit which has been prepared for your signature and your sister's signature granting
you burials rights in spaces 1 -4 of Block 15, Lot 5.
Please review this affidavit and if you're both in agreement, please have your signatures witnessed and
notarized, filling the information as indicated.
When the affidavit is completed /notarized return the original to my attention to:
City of Clearwater
Official Records and Legislative Services Dept.
1
112 S. Osceola Ave.
Clearwater, FL 33756
Our records will be changed and /or notated to reflect this information.
If you have any additional questions please give me a call.
Thank You !!
Judith LaCosse
Staff Asst
City of Clearwater
ORLS Dept.
727 - 562 -4093
From: Mary Kay Wells [mailto:mkwells48Cagmail.com]
Sent: Friday, June 09, 2017 12:56 PM
To: LaCosse, Judith
Cc: Jim and Mary Kay Wells; Barkoontz
Subject: Re: Clearwater Municipal Cemetery Question
Judy,
So sorry! I forgot to include it! Barbara Koontz's email address is:
barkoontz @aol.com
Thanks!
Mary Kay
Sent from my iPad
On Jun 9, 2017, at 12:48 PM, <Judith.LaCosse @myClearwater.com>
<Judith.LaCosse @myClearwater.com> wrote:
Thank you for the information. I will work on the affidavit and will forward you a copy
by next week.
Please provide the email address for your sister.
Thank You !!
Judith LaCosse
Staff Asst
City of Clearwater
ORLS Dept.
727- 562 -4093
From: Mary Kay Wells [mailto:mkwells48@gmail.com]
Sent: Friday, June 09, 2017 12:26 PM
To: LaCosse, Judith
Cc: Jim and Mary Kay Wells; Barkoontz
Subject: Clearwater Municipal Cemetery Question
2
Dear Judy,
Below you will find the requested information regarding use of family burial plots
for future burials in Block 15 Lot 5:
Plot 1: James Franklin Wells
Plot 2: Mary Kay Wells
Plot 3: Barbara Anne Koontz
Plot 4: Etta Wadene Brenton
Barbara Koontz and I are siblings and direct descendants of Mr and Mrs Oliver
Snodgrass (our grandparents) and Mr & Mrs Glenn Koontz (our parents).
Please confirm for us that we will be able to have a joint bronze plaque for each
couple placed on the appropriate 2 plots. This will be similar to how the present
plaques mark the graves of our parents and grandparents.
Once again, thank you for all of your prompt assistance. We await instructions on
how to finalize these arrangements.
Mary Kay Wells
Sent from my iPad
On Jun 9, 2017, at 11:18 AM, <Judith.LaCosse @myClearwater.com>
<Judith.LaCosse @myClearwater.com> wrote:
Ms. Wells,
I will have to say it was both The National Cremation Society and our
department's oversite. Apparently we never received the $30.00
staking fee from National Cremation Society and we didn't follow up
with them so we missed updating the cemetery program with the burial
information.
We apologize for this oversite.
Judith LaCosse
Staff Asst
City of Clearwater
ORLS Dept.
727 - 562 -4093
From: Mary Kay Wells [mailto:mkwells48(agmail.com]
Sent: Thursday, June 08, 2017 9:09 PM
To: LaCosse, Judith
Subject: Re: [POSSIBLE SPAM] Clearwater Municipal Cemetery
Question
Dear Judith,
3
Thank you for updating our family records! We had no idea that
they were incomplete. Out of curiosity, was the recording of my
mother's burial an over site on the part of The National Cremation
Society or at the Clearwater Municipal Cemetery office?
I have talked with my brother and sister, and have received their
permission for my husband and me to be buried with my parents.
But we would appreciate clarification of how many urns are legally
allowed to be added to each of their plots. We all plan to be
cremated and would like to understand the possible options.
Thanks again for all you are doing to advise our family regarding
future burial needs!
Mary Kay Wells
Sent from my iPad
On Jun 8, 2017, at 2:46 PM,
<Judith.LaCosse @myC learwater. com>
<Judith.LaCosse @myClearwater.com> wrote:
Ms. Wells,
I found out that the date of burial for your mother was
July 6, 2007 by the National Cremation Society of
Clearwater.
This information has been updated in our cemetery
program.
I did find a copy in our files of your parents cemetery
deed that states their ownership to Block 15, Lot 5,
Spaces 1 and 2.
We need to know if there are other descendants /heirs
of your parents that might be interested as well to use
these spaces.
Please advise,
Thank You.
Judith LaCosse
Staff Asst
City of Clearwater
ORLS Dept.
727 - 562 -4093
From: LaCosse, Judith
Sent: Wednesday, June 07, 2017 12:56 PM
To: 'Mary Kay Wells'
4
Subject: RE: [POSSIBLE SPAM] Clearwater Municipal
Cemetery Question
Ms. Wells,
I will call the The National Cremation Society regarding
this matter and will let you know.
Thanks !!
Judith LaCosse
Staff Asst
City of Clearwater
ORLS Dept.
727 -562 -4093
From: Mary Kay Wells [mailto:mkwells48 @gmail.com]
Sent: Wednesday, June 07, 2017 12:52 PM
To: LaCosse, Judith
Subject: Re: [POSSIBLE SPAM] Clearwater Municipal
Cemetery Question
Thank you for your research efforts!
BTW...there is a bronze plaque at my mother's
gravesite and the burial or her urn was handled by
The National Cremation Society at the time of her
death. I am puzzled as to why that would not have
been recorded by them.
Mary Kay
Sent from my iPhone
On Jun 7, 2017, at 12:36 PM,
<Judith.LaCosse@myClearwater.com>
<Judith.LaCosse @myClearwater.com> wrote:
Thank you for the information.
I will update our cemetery program to
reflect this information.
I will research on documentation
needed to authorize your burial rights
and will contact you.
Judith LaCosse
Staff Asst
City of Clearwater
ORLS Dept.
727 - 562 -4093
5
1
Status of Block: 15 Lot: 5 as of 06/09/2017
INTERMENTS:
SPACE BURIALTYPE DECL
DECF DECM BIRTH DEATH INTERRED
1 URN KOONTZ GLENN H 1/1/1922 10 / 10 / 1986 10/10/1986
2 URN KOONTZ RUTH T 3/14/1922 06 / 22 / 2007 7/6/2007
3 FULL SNODGRASS OLIVER 11/26/1905 05 / 08 / 1985 5/11/1985
4 FULL SNODGRASS DRAXIE P 3/11/1898 02 / 16 / 1985 2/20/1985
DISINTERMENTS FROM SPACE:
No Matching Records
REINTERMENTS:
No Matching Records
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