Murray, Mary LouDate: / ' / c 0d 0
Funeral Home / Monument Company:
Cemetery CaII Work Sheet
Ro s s Ft -ste r
Contact Name: Tel. #:'A-7- 56a-ao7b
Reason for call: ✓ Staking Request (Interment/Disinterment)
Affidavit (Burial Rights)
Monument (Marker) being placed (No fee for staking of monument)
Fax #:
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For:
Block Lot
Space
Date: / / 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:
Block 7 Lot 33
Urn Space ✓
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Space 2
Date of Birth: 3 / 15 / )1"0- Date of Death
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Date of Burial: 4' / ) / a -D at> Time: 11:G. /pm
$30.00 Staking Fee (Funeral Home) - received on: 5 / ab / amt °
Copy of permit emailed to Mark Tokar, cc: Matt Anderson/P&R on: ti / 3 /
**************************************************************************************************
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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
LaCosse, Judith
From: Chaplinsky, Timothy
Sent: Thursday, May 28, 2020 7:54 AM
To: LaCosse, Judith; Brigman, Nathan; Anderson, Matthew
Cc: Vaughan, Karen
Subject: Re: Cemetery Staking Request - Urn Burial
West side of cemetery 4 green flags,
North east corner under tree.
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From: LaCosse, Judith <Judith.LaCosse@myClearwater.com>
Sent: Wednesday, May 27, 2020 3:38:08 PM
To: Brigman, Nathan <Nathan.Brigman@MyClearwater.com>; Anderson, Matthew
<matthew.anderson@myclearwater.com>
Cc: Chaplinsky, Timothy <Tim.Chaplinsky@MyClearwater.com>; Vaughan, Karen <Karen.Vaughan@MyClearwater.com>
Subject: RE: Cemetery Staking Request - Urn Burial
Perfect. I just spoke to the funeral director at Moss Feaster and tomorrow morning will be fine.
From: Brigman, Nathan <Nathan.Brigman@MyClearwater.com>
Sent: Wednesday, May 27, 2020 3:10 PM
To: LaCosse, Judith <Judith.LaCosse@myClearwater.com>; Anderson, Matthew
<matthew.anderson@myclearwater.com>
Cc: Chaplinsky, Timothy <Tim.Chaplinsky@MyClearwater.com>; Vaughan, Karen <Karen.Vaughan@MyClearwater.com>
Subject: Re: Cemetery Staking Request - Urn Burial
The earliest it could be done is tomorrow. Staff has already left for the day. We did not rush since burial is to be held on
Monday.
Tim,
Please handle this tomorrow am. and report back when done.
Thank You,
Nathan Brigman
City of Clearwater Parks and Recreation Department
Landscape Manager
B.S. Ornamental Horticulture
ISA Certified Arborist
Office - (727) 562-4270 ext 7808
From: LaCosse, Judith <Judith.LaCosse(mvClearwater.com>
Sent: Wednesday, May 27, 2020 3:06:19 PM
To: Anderson, Matthew<matthew.anderson@myclearwater.com>
Cc: Brigman, Nathan <Nathan.Brigman@MvClearwater.com>; Chaplinsky, Timothy
<Tim.Chaplinsky@MyClearwater.com>; Vaughan, Karen <Karen.Vaughan@MyClearwater.com>
Subject: FW: Cemetery Staking Request - Urn Burial
1
I
Hello,
•
Please advise if this staking request will be done soon. I received a call from the funeral home asking if it could be done
today.
Let me know.
Thank You.
Judith LaCosse
StaffAsst
City of Clearwater
ORLS Dept.
727-562-4093
From: LaCosse, Judith
Sent: Tuesday, May 26, 2020 2:11 PM
To: Anderson, Matthew<matthew.anderson@mvclearwater.com>
Cc: Brigman, Nathan <Nathan.Brigman@MyClearwater.com>; Chaplinsky, Timothy
<Tim.Chaplinsky@myclearwater.com>; Vaughan, Karen<Karen.Vaughan@MYClearwater.com>
Subject: Cemetery Staking Request - Urn Burial
Importance: High
Hello,
We received a cemetery staking request this afternoon from Joseph Gambino at Moss Feaster for an Urn burial.
Please stake Block 7, Lot 33, Space 1
Deceased Name: Mary Lou Murray - DOB: 3/19/1946 DOD: 5/1/2020
Note: Per Moss Feaster Mary Lou Murray is to be buried with her father, John C. Ward, Sr. in Space 1 (already there)
and was a full burial.
Other burials nearby in Block 7, Lot 33:
Space 1= John C. Ward, Sr. — (full burial)
Space 2 = Mary E. Ward — (full burial)
The burial is scheduled for next Monday, June 1St at around 11:00 a.m.
Please let me know the color of the flaps being used so that I could notify the funeral home.
Thank You.
Judith LaCosse
Staff Asst
City of Clearwater
ORLS Dept.
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OFFICIAL. RECORDS AND
LEGISLATIVE SERVICES
May 29, 2020
CITY OF CLEARWATER
Moss Feaster Funeral Home
and Cremation Services
693 South Belcher Road
Clearwater, FL 33764
Attn: Joseph Gambino
Dear Mr. Gambino:
POST OFFICE BOX 4748, CLEARWATER, FLORIDA 33758-4748
600 CLEVELAND STREET, SATE 600, CLEARWATER, FL 33755
TELEPHONE (727) 562-4090 FAx (727) 562-4086
We received the Cemetery Staking Fee check #616 in the amount of $30.00 for the interment of
Mary Lou Murray in Block 7, Lot 33, Space 1.
Attached you will find our receipt No. 452029.
Thank you,
lith LaCosse
Staff Assistant
Mark Bunker, Councilmember
Kathleen Beckman, Councilmember
Frank V. Hibbard, Mayor
David Allbritton, Councilmember
Hoyt Hamilton, Councilmember
"Equal Employment and Affirmative Action Employer"