Sowell, Carolyn (2)Cemetery Call Work Sheet
Date: g / �� / 3-°18'
Funeral Home / Monument Company: C-7 o .tKe nt CO
Contact Name:
Kev +n
Tel. #: ° - L Fax #:
Reason for call: Staking Request (Interment/Disinterment)
Affidavit (Burial Rights)
Monument (Marker) being placed (No fee for staking of monument)
For: av-o-4n So co JO
Block 1 a Lot T7 Space a-
Date:'l / 1 / d-01 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
Owner of Plot:
Deceased Name:
Urn Space
Block Lot Space
Date of Birth: / / Date of Death / /
Date of Burial: / /
Time: am /pm
$30.00 Staking Fee (Funeral Home) — received on: / /
Yde
1),yR 4ipkce LO GA.
4±4. k 4,1-1/1, 6 Qkx. .
Copy of permit emailed to Mark Tokar, cc: Matt Anderson /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 11/15/17
Status of Block: 12 Lot: 97 as of 08/28/2018
I
INTERMENTS:
SPACE BURIALTYPE DECL
DECF
DECM BIRTH DEATH INTERRED
PERMIT
1 FULL SPEARS JOHN L 1/1/1900 06 / 28 / 1966 6/28/1966 516
2 FULL SOWELL CAROLYN 10/11/1943 09 / 17 / 2016 9/22/2016 1458
3 FULL CRIBBS HATTIE M 4/7/1908 10 / 22 / 1990 10/24/1990 1914
4 FULL CRIBBS, JR LUTHER J 10/15/1928 12 / 10 / 1993 12/14/1993 2129
DISINTERMENTS FROM SPACE:
No Matching Records
REINTERMENTS:
No Matching Records
Page 1 of 1
Re: Cemetery Staking Requests for Monument Placements (3)
Tokar, Mark
Tue 8/28/2018 11:50 AM
To:LaCosse, Judith <Judith.LaCosse @myClearwater.com >;
cc.:Anderson, Matthew <matthew.anderson @myclearwater.com >; Vaughan, Karen < Karen .Vaughan @MyClearwater.com >;
Amon jr- orange flags
Padgett- white flags
Sowell- blue flags
Mark Tokar
Get Outlook for iOS
From: LaCosse, Judith
Sent: Tuesday, August 28, 2018 10:31:23 AM
To: Tokar, Mark
Cc: Anderson, Matthew; Vaughan, Karen
Subject: Cemetery Staking Requests for Monument Placements (3)
We received a staking request from Kevin of Cycadia Monument Co. for staking requests
for Monument Placements for the 3 Spaces below in red:
Block 11, Lot 28, Space 3 = Charles R Amon, Jr - (full burial)
Other burials nearby in this plot:
Space 1= Herbert R Fredrickson (full)
Space 2 = Bertha E Fredrickson (full)
Block 12, Lot 34, Space 2 = Edna G Padgett - (full burial)
Other burials nearby in this plot:
Space 1= Vernie L Padgett (full)
Space 3 = Marie L Laurin (full)
Space 4 = Edward Laurin (full)
Block 12, Lot 97, Space 2 = Carolyn Sowell - (full burial)
Other burials nearby in this plot:
Space 1= John L Spears (full)
Space 3 = Hattie M Cribbs (full)
Space 4 = Luther J Cribbs, Jr (full)
Staking is needed by this Saturday, September 1st
Please advise me of the color of the flags being used so that we could notify the monument
company.
Thank You !!
Judith LaCosse
Staff Asst
City of Clearwater
ORLS Dept.
727 -562 -4093