Miller, ElizabethDate: G_ / a / ao a)
Funeral Home / Monument Company:
Contact Name: Kobev7:1 "`��
Cemetery CaII Work Sheet
Tel.#: grFax#: ��- f �-305)
Email: /ts 6-Axt - 0yuLca (-) vt .
Reason for call:
Staking Request — Interment - ($30.00 Staking Fee)
(One full burial and one urn, or two urns per space)
Full Burial ✓ C 64,N. Li. Urn Space
Owner of Plot: I\ 6r-4 Iti
Deceased Name: �1 M' -
Block tLot :- t Space 4 -
Date of Birth: 3 / 1/3,t Date of Death C( / ( / )001 -
Date
°0Date of Burial: `'I / 5- / `' a Time: q,00 afrji pm
Monument (Marker) being placed - (No fee for staking of monument)
For:
Block Lot Space
Date: / / Time:
Affidavit (Burial Rights)
Verifying Burial space
Other reason:
**************************************************************************************************
(Send email to P&R to stake the space)
Notify funeral home/monument company with color of the flags used to mark the space
$30:ee Staking Fee (Funeral Home) — received on: Cl / /
1,50, o�
Copy of permit emailed to Nathan Brigman, cc: Matt Anderson/P&R on: /
cie.,(Y41C 4;V
**************************************************************************************************
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
ORLS/Cemetery/FormsPermitsTemplates/Cemetery Call Work Sheet -20
Revised 8/28/2020
LaCosse, Judith
From: Brigman, Nathan
Sent: Friday, September 4, 2020 9:10 AM
To: LaCosse, Judith; Sheeler, Jarvis
Cc: Chaplinsky, Timothy; Anderson, Matthew; Vaughan, Karen; Horsely, Christopher
Subject: Re: Cemetery Staking Request - Full burial
Thank you Judith. You as well.
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@myClearwater.com>
Sent: Friday, September 4, 2020 8:21:15 AM
To: Sheeler, Jarvis <Jarvis.Sheeler@MyClearwater.com>; Brigman, Nathan <Nathan.Brigman@MyClearwater.com>
Cc: Chaplinsky, Timothy <Tim.Chaplinsky@MyClearwater.com>; Anderson, Matthew
<matthew.anderson@myclearwater.com>; Vaughan, Karen <Karen.Vaughan@MyClearwater.com>; Horsely, Christopher
<christopher.horsely@MyClearwater.com>
Subject: RE: Cemetery Staking Request - Full burial
Thank You. I have notified the funeral home that the staking has been completed.
Have a nice day II
Judith LaCosse
Staff Asst
City of Clearwater
ORLS Dept.
727-562-4093
From: Sheeler, Jarvis <Jarvis.Sheeler@MyClearwater.com>
Sent: Friday, September 4, 2020 6:47 AM
To: Brigman, Nathan <Nathan.Brigman@MyClearwater.com>; LaCosse, Judith <Judith.LaCosse@myClearwater.com>
Cc: Chaplinsky, Timothy <Tim.Chaplinsky@MyClearwater.com>; Anderson, Matthew
<matthew.anderson@myclearwater.com>; Vaughan, Karen <Karen.Vaughan@MyClearwater.com>; Horsely, Christopher
<christopher.horsely@MyClearwater.com>
Subject: Re: Cemetery Staking Request - Full burial
Staking is completed with orange flagging. Block 16,Iot 29, space 4 is located on the southwest -side of the
westside of Cernetry.
1
From: Sheeler, Jarvis <Jarvis.Sheeler@MyClearwater.com>
Sent: Friday, September 4, 2020 5:46 AM
To: Brigman, Nathan <Nathan.Brigman@MvClearwater.com>; LaCosse, Judith <Judith.LaCosse@myClearwater.com>
Cc: Chaplinsky, Timothy <Tim.Chaplinsky@MyClearwater.com>; Anderson, Matthew
<matthew.anderson@myclearwater.com>; Vaughan, Karen <Karen.Vaughan@MyClearwater.com>; Horsely, Christopher
<christopher.horsely@MyClearwater.com>
Subject: Re: Cemetery Staking Request - Full burial
Will stake out this morning.
From: Brigman, Nathan <Nathan.Brigman@MyClearwater.com>
Sent: Thursday, September 3, 2020 4:30 PM
To: LaCosse, Judith <Judith.LaCosse@myClearwater.com>; Sheeler, Jarvis <Jarvis.Sheeler@MyClearwater.com>
Cc: Chaplinsky, Timothy <Tim.Chaplinsky@MyClearwater.com>; Anderson, Matthew
<matthew.anderson@myclearwater.com>; Vaughan, Karen <Karen.Vaughan@MyClearwater.com>; Horsely, Christopher
<christopher.horsely@MyClearwater.com>
Subject: Re: Cemetery Staking Request - Full burial
Judith,
My staff had already left for the day and I had to get my daughter from school. We come in at 6am so Tim and Jarvis will
handle as soon as there is enough daylight to get out there. Sorry it could not be done sooner.
You can continue to copy Jarvis, Tim and Matt. This will give us some redundancy in case something comes up.
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@myClearwater.com>
Sent: Thursday, September 3, 2020 3:58:24 PM
To: Brigman, Nathan <Nathan.Brigman@MyClearwater.com>; Sheeler, Jarvis <Jarvis.Sheeler@MyClearwater.com>
Cc: Chaplinsky, Timothy <Tim.Chaplinsky@MyClearwater.com>; Anderson, Matthew
<matthew.anderson@myclearwater.com>; Vaughan, Karen <Karen.Vaughan@MyClearwater.com>; Horsely, Christopher
<christopher.horsely@MyClearwater.com>
Subject: RE: Cemetery Staking Request - Full burial
Nathan,
Will do. Do we still copy Timothy Chaplinsky and Matthew Anderson for staking requests as well ?
Let me know.
Thank You.
2
Judith LaCosse
Staff Asst
City of Clearwater
ORLS Dept.
727-562-4093
From: Brigman, Nathan <Nathan.Brigman@MyClearwater.com>
Sent: Thursday, September 3, 2020 3:32 PM
To: LaCosse, Judith <Judith.LaCosse@myClearwater.com>; Sheeler, Jarvis<Jarvis.Sheeler@MyClearwater.com>
Cc: Chaplinsky, Timothy <Tim.Chaplinsky@MyClearwater.com>; Anderson, Matthew
<matthew.anderson@myclearwater.com>; Vaughan, Karen <Karen.Vaughan@MyClearwater.com>; Horsely, Christopher
<christopher.horsely@MyClearwater.com>
Subject: Re: Cemetery Staking Request - Full burial
Judith,
Can you please copy Jarvis Sheeler in the future. He is the new South team supervisor.
We will address first thing in the morning and report back to you ASAP
Jarvis,
Please respond when completed.
Thank You,
Nathan Brigman
City of Clearwater Parks and Recreation DepartmentD
Landscape Manager
B.S. Ornamental Horticulture
ISA Certified Arborist
Office - (727) 562-4270 ext 7808
From: LaCosse, Judith <Judith.LaCosse@myClearwater.com>
Sent: Thursday, September 3, 2020 2:53:42 PM
To: Brigman, Nathan <Nathan.Brigman@MyClearwater.com>
Cc: Chaplinsky, Timothy <Tim.Chaplinsky@MyClearwater.com>; Anderson, Matthew
<matthew.anderson@myclearwater.com>; Vaughan, Karen <Karen.Vaughan@MyClearwater.com>; Horsely, Christopher
<christopher.horsely@MyClearwater.com>
Subject: FW: Cemetery Staking Request - Full burial
Hello,
The funeral home just called and they need to know the color of the flags being used to mark Space 4 of Block 16, Lot 29
per email below.
The service is scheduled for Saturday at around 9 a.m. and they would like to get started in getting the area ready for
the burial.
Please advise as soon as you can.
Thank You.
3
Judith LaCosse
Staff Asst
City of Clearwater
ORLS Dept.
727-562-4093
From: LaCosse, Judith
Sent: Wednesday, September 2, 2020 3:47 PM
To: Brigman, Nathan <Nathan.Brigman@MyClearwater.com>
Cc: Anderson, Matthew<matthew.andersonPmyclearwater.com>; Chaplinsky, Timothy
<Tim.Chaplinsky@myclearwater.com>; Vaughan, Karen <Karen.Vaughan@MyClearwater.com>; Horsely, Christopher
<christopher.horsely@MyClearwater.com>
Subject: Cemetery Staking Request - Full burial
Importance: High
Good Afternoon,
We received a cemetery staking request this afternoon from Robert Young of Young's Funeral Home for full burial for
Elizabeth Miller.
Please stake Block 16, Lot 29, Space 4
(See attached burial status for block 16, Lot 29)
Please let us know the color of the flags being used so that we could notify the funeral home as soon as possible.
If you have any questions please give me a call at 727-562-4093.
Thanks !!
Judith LaCosse
Staff Asst
City of Clearwater
ORLS Dept.
727-562-4093
4
Status of Block: 16 LOT: 29 as of 9/2/2020
INTERMENTS
BURIAL DECL DECF DECM BIRTH DEATH INTERRED PERMIT
SP TYPE
1 FULL JACKSON GEORGE 5/18/1914 2/12/1997 2/22/1997 2304
2 FULL HARVEY REGINALD T 7/22/1956 2/27/1997 3/8/1997 2306
3 FULL MILLER ABRAHAM 4/23/1931 7/20/2008 7/26/2008 2591
DISINTERMENTS
REINTERMENTS
September 4, 2020
Attn: Robert Young
Funeral Home: Young's Funeral Home
Fax: 727-442-8308
Included is a copy of the Cemetery Map
(# in the circle is the Block, # in the square is the Lot, space do not show)
Deceased: Elizabeth Miller
Gravesite: Block 16, Lot 29, Space 4
Full Burial
Parks and Recreation Dept. has staked the space with orange flags.
Interment — ($30.00 staking fee (Weekdays) or $50.00 (Saturday, Sunday,
Legal Holiday)
_ Placement of a marker — (No fee)
Date of Burial/Time: 9/5/2020 — 9:00 a.m.
(See attached burial status for block 16 , Lot 29 )
Staking Fee: $50.00 — (Saturday Interment)
Please make check payable to: City of Clearwater
Mail to:
City of Clearwater
Official Records Dept.
Bank of America Bldg.
600 Cleveland St., Suite 600
Clearwater, FL 33755
Please contact our dept. at 727-562-4093 if you have any questions.
ORLS/Cemetery/Correspondence/Cemetery Fax -Master
Rev. 8/28/2020
iintttlj-Vountj6 Ituteral i iu nt Jnr
1003 f ossa St
elranuatrr, rt 33756
PAY TO THE City of, Clearwater $ **50.00
ORDER OF
Fifty and 00/100**** . *.«.*«.,«.r.*. .«********«., ********* ,,k«, *,* *****,.**** ********** 1k**.. **i-kk* **************** * f
DOLLARS L
REGIONS BANK
63-466/631
15792
CHECK fm.
9/10/2020
City of Clearwater
100 So. Myrtle Ave
Clearwater, FL 337
MEMO
E.Miiler(Stkng) &' ' aurrloai • • su
0000 L5 79.2" 1:0631,04668 328 LOLL], L 9"
PP
o ° 0