Barron, ElizabethCemetery Call Work Sheet
Date: 3 / a`l / dodo
Funeral Home / Monument Company: Cy c `�4�' �� ��Krt Co
Contact Name: Kev ; h C- • Tel. #: 7).1- 9`? - 15sI Fax #:
Reason for call: '/ Staking Request (Interment/Disinterment)
Affidavit (Burial Rights)
V. Monument (Marker) being placed (No fee for staking of monument)
For: v✓ rk..."
Block (a Lot ° Space 7
Date: 3 / 0-L' / d°-1' 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 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: 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
Date:
/ ) S' / aoao
Cemetery Call Work Sheet
Funeral Home / Monument Company: kO S S
Contact Name: -Pa-aZ h^. Tel. #: 1a�- 5 -d°70 Fax #:
Reason for call: Staking Request (Interment/Disinterment)
Affidavit (Burial Rights)
Monument (Marker) being placed (No fee for staking of monument)
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)
3/iVIao
Full Burial Urn Space k• -v- -f
Owner of Plot: -� '�� P
Deceased Name: 411 � ti� r
Block Lot a° Space W �,Q�
f
Date of Birth: / 't 13 Date of Death d / / I cN 7
No 5}}t�-N� v,,vice
Date of Burial: / / 1)..eTi
e me: am/pm - �
C�"`Y "`'�'
vvti
G -
M
$30.00 Staking Fee (Funeral Home) - received on: (4' / 30/ ,;tado P' (01`t`f' C_P w 4.c
Copy of permit emailed to Mark Tokar, cc: Matt Anderson/P&R on: / / `).061
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
159/..
Revised 11/15/17
LaCosse, Judith
From: Chaplinsky, Timothy
Sent: Wednesday, March 18, 2020 11:37 AM
To: LaCosse, Judith
Cc: Anderson, Matthew; Brigman, Nathan; Vaughan, Karen
Subject: Re: Municipal Cemetery Staking Request - Urn Burial
Green flags east side of cemetery.
Please note : for vault complete entire plot is covered in marble chips
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From: LaCosse, Judith <Judith.LaCosse@myClearwater.com>
Sent: Wednesday, March 18, 2020 10:42:10 AM
To: Chaplinsky, Timothy <Tim.Chaplinsky@MyClearwater.com>
Cc: Anderson, Matthew<matthew.anderson@myclearwater.com>; Brigman, Nathan
<Nathan.Brigman@MyClearwater.com>; Vaughan, Karen<Karen.Vaughan@MyClearwater.com>
Subject: Municipal Cemetery Staking Request - Urn Burial
Good Morning,
We received a staking request from Paul McLaren fromMoss Feaster Funeral Home for a staking request for
an Urn burial for:
Decease Name: Elizabeth Barron in Block 6, Lot 20, Space 7
Other burials nearby in this location:
Space 1= Mary A Dillard - (full)
Space 2 = S N Dillard - (full)
Space 3 = Elizabeth N Dillard - (full)
Space 4 = Albert N Dillard - (full)
Space 5 = Elsie H Dillard - (full)
Space 6 = Isabel D Whatley — (full)
Staking is needed as soon as possible. No specific date/time given as there will be no service just the interment of
cremated remains.
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
1
LaCosse, Judith
From: LaCosse, Judith
Sent: Wednesday, March 25, 2020 10:14 AM
To: Chaplinsky, Timothy
Cc: Anderson, Matthew; Brigman, Nathan; Vaughan, Karen
Subject: RE: Cemetery Staking Request for Placement of a marker
Thanks Tim,
I will let Kevin from Cycadia Monument Co. know the color of the flags for the headstone.
The burial was supposed to be done by Moss Feaster but they did not have a specific date, perhaps they have not yet
done the urn burial.
Judith LaCosse
Staff Asst
City of Clearwater
ORDS Dept.
727-562-4093
From: Chaplinsky, Timothy <Tim.Chaplinsky@MyClearwater.com>
Sent: Wednesday, March 25, 2020 10:04 AM
To: LaCosse, Judith <Judith.LaCosse@myClearwater.com>
Cc: Anderson, Matthew <matthew.anderson@myclearwater.com>; Brigman, Nathan
<Nathan.Brigman@MyClearwater.com>; Vaughan, Karen<Karen.Vaughan@MyClearwater.com>
Subject: Re: Cemetery Staking Request for Placement of a marker
Flags for headstone are orange,Doesn't appear to have any recent digging in plot green flags still in place for burial.
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From: LaCosse, Judith <Judith.LaCosse@myClearwater.com>
Sent: Tuesday, March 24, 2020 2:40:06 PM
To: Chaplinsky, Timothy <Tim.Chaplinsky@MyClearwater.com>
Cc: Anderson, Matthew <matthew.anderson@myclearwater.com>; Brigman, Nathan
<Nathan.Brigman@MyClearwater.com>; Vaughan, Karen<Karen.Vaughan@MyClearwater.com>
Subject: Cemetery Staking Request for Placement of a marker
Good Afternoon,
We received a call from Kevin from Cycadia Monument Co. for a staking request for placement of a marker for:
Decease Name: Elizabeth Barron in Block 6, Lot 20, Space 7
Other burials nearby in this location:
Space 1 = Mary A Dillard - (full)
Space 2 = S N Dillard - (full)
1
Space 3 = Elizabeth N Dillard - (full)
Space 4 = Albert N Dillard - (full)
Space 5 = Elsie H Dillard - (full)
Space 6 = Isabel D Whatley — (full)
Staking is needed by this Thursday, March 26th.
FYI: You recently had staked this space for the actual urn burial which has already been done.
Please advise me of the color of the flags being used so that we could notify Kevin/Cycadia Monument Co.
Thank You.
Judith LaCosse
Staff Asst
City of Clearwater
ORLS Dept.
727-562-4093
2
JOHN D BARRON
DEBORA W BARRON
4102 MCCALL LANE
MARIANNA, FL 32448-7140
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