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HomeMy WebLinkAbout01-06-05Name Unit_I Block Lot 'r Date of Mark -out 3 2 Date of Burial �.� /�� Time % Name of Funeral Home Authorized by 04/24/2017 10:11 716708 P.001/001 MYOF H ME OF PELICAN LAND Sebastian Cerneter Ph# 772-589-25254 A Fax# 772-228992 •Y/A e� Site Ian for Marker Instc I ation Funeral Home:,STRU 1623 NORTH CENTRALAVENUE, K FUNERAL HOME SEBAS71AN, &CREMATORY.° FLORI A.329S$ 7TYp!e8&'LSJze of Marker: '3� UYY1GlS Name X I"Ox 0"�v O—(p I—ILS 3,, H n r� . DOB: OB: D: d2— 7 Unit: 1 Unit: tp 131 ck: gi L ot: Size T772 1' 2' ............................................ Foundationaterial Dry mix, cox s sting of a ba of concrete ntly) includes f at:grass marker. Larger than P x 2'..............................Formed and cured concret eluding base. Approved by: Date -! 2-X Marked out by: IK Dat i Foundation Poured by: .r o o,/DI7 Dat y�l% 7• Foundation Material % Date -4