Errickson, Warren LamontCemetery Call Work Sheet
Date: l° / 9 /
Funeral Home / Monument Company: videc S
Contact Name: ikr eve✓' Tel. #:-7?1 ' •` - qaO ax #:
/ Serf ��,u�e l0
Reason for call: V Staking Request (Interment/Disinterment) t%,-/a-011?
Affidavit (Burial Rights)
Monument (Marker) being placed
For:
Block Lot Space
Date: / / Time:
(No fee for staking of monument)
(o%ta /IS
(Send email to P &R)
Verifying Burial space
Other reason:
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N a-f,1:.LS
******************************************************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
R.
Interment: (One full burial and one urn, or two urns per space)
Full Burial Urn Space
Owner of Plot: Lk-SO-
Deceased Name: 1/36 t �-` ti.c Ct .rr� c st
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Block Lot 35 Space �O
Date of Birth: la- / a° / 19 51 Date of Death g / 0 1 5 / 0 1 ° 1 S )
Date of Burial: 1° / 13 / a o Time: `off -:OG' ;"
$30.00 Staking Fee (Funeral Home) - received on: ' ° / `( / a-° (S' [3 kAir kr;eveAf/Ve_+erai4s
k.
Copy of permit emailed to Mark Tokar, cc: Cherise Sarnoff /P &R on: / /�S Cry.
******************************************************************* * * * * * * * * * * * *** * * * * * * * * * * * * * * * **
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: 6 Lot: 35 as of 10/10/2018
1
INTERMENTS:
SPACE BURIALTYPE DECL DECF DECM BIRTH DEATH INTERRED PERMIT
2 FULL ERRICKSON ALBERT W 1/7/1890 03 / 09 / 1974 5/12/1974 1023
3 FULL ERRICKSON ETHEL 7/6/1900 11 / 11 / 2000 11/14/2000 2464
4 FULL ERRICKSON WILLIAM E 9/20/1830 02 / 29 / 1924 2/29/1924 0
5 FULL ERRICKSON HELEN L 3/23/1862 09 / 09 / 1930 9/9/1930 33333
DISINTERMENTS FROM SPACE:
No Matching Records
REINTERMENTS:
No Matching Records
Page 1 of 1
10/10/2018
Mail - Judith.LaCosse @myCIearwater.com
'Re: Cemetery Staking Request - Urn Burial
Tokar, Mark
Wed 10/10/2018 11:44 AM
To: LaCosse, Judith < Judith .LaCosse @myClearwater.com >;
Cc:Anderson, Matthew < matthew .anderson @myclearwateccom>; DeWitt, Brian <Brian.DeWitt@MyClearwateccom >;
White flags.
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From: LaCosse, Judith
Sent: Wednesday, October 10, 2018 9:54:49 AM
To: Tokar, Mark
Cc: Anderson, Matthew; DeWitt, Brian
Subject: Cemetery Staking Request - Urn Burial
Good Morning,
We received a staking request from Blair Kriever from Veterans Funeral Care for a staking request for an Urn burial for:
Decease Name: Warren Lamont Errickson in Block 6. Lot 35. Space 6
Other burials nearby in this plot:
Space 2 = Albert W Errickson - (full)
Space 3 = Ethel Errickson - (full)
Space 4 = William E Errickson - (full)
Space 5 = Helen L Errickson - (full)
Staking is needed by this Saturday. October 13th at 2:00 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
https : / /outlook.office365.com /owa/ ?path= /mail /inbox/rp 1/1
CLEARWATER CARETAKER
CLEARWATER, FL
BURIAL PERMIT
PERMIT # 1470
October 29, 2018
Permission is hereby granted for burial of:
Name of Deceased: WARREN L ERRICKSON Burial Type: URN
Owner of Property: JAMES H ERRICKSON &
Block • 6 Lot: 35 Space: 6 Date of Birth: December 20, 1957
Date of Death: August 25, 2018 Date of Burial: October 13, 2018
Funeral Home Director: BLAIR KRIEVER/VETERANS FUNERAL CARE
Time: 14 :00 Staking Fee: 30.00 Date Paid: October 9, 2018
Clearwater Cemetery