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Disposition PermitDISPOSITION PERMIT DECEDENT'S NAME LOLA BERENS MAYNARD AKA/ LOLA MAYNARD GENDER FEMALE DATE OF BIRTH /AGE 08/02/1932 / 82 DATE OF DEATH 11/14/2014 PRESBYTERIAN HOMES ON LK MTKA PLACE OF DEATH 4527 SHORELINE DRIVE SPRING PARK, HENNEPIN, MINNESOTA FUNERAL DIRECTOR CHARLES B WILLARD M3572 HUBER FUNERAL HOME & CREMATION / LIC # 0144 FUNERAL HOME OR 520 SECOND STREET OTHER ENTITY EXCELSIOR MINNESOTA PLACE OF DISPOSITION CEMETERY CHANHASSEN PIONEER CEMETERY CHANHASSEN CARVER MINNESOTA According to Minnesota Statutes, section 149A.93, subdivision 3, section 144.221, and Minnesota Rules, part 4601.1500, the fact of death has been filed with the Office of Vital Records. ru Molly Mulcahy Crawford STATE REGISTRAR DISPOSITION PERMIT ISSUE DATE 11/17/2014 12:43 PM (SIGNATURE OF FINAL DISPOSITION FACILITY OFFICIAL) (PRINT NAME OF FINAL DISPOSITION FACILITY OFFICIAL) Rev 12/2013