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Cemetery RecordLot 27.3 Grave Status Occupied Update Date 10/24/1997 Place of Birth Germany Place of Death Chanhassen, Carver County, Minnesota Age Occupant Information Name Henriette or Tessmann Sex Female Social Sec. No. Ferdinand Heintz Date of Birth 4/8/1840 Date of Death 4/1/1924 Interment Date 4/5/1924 Cause of Death Apoplexy (CCDR) Place of Birth Germany Place of Death Chanhassen, Carver County, Minnesota Age 83 Marital Status Widow Mother Unknown Father Ferdinand Heintz Children Mary, Herman Occupation Military Status Baptized Purchaser Information Purchased By Henriette or Tessmann Street City, State, Zip Phone Date Purchased 11/14/1911 Amount Fee Paid $15.00 Date Int Fee Paid Interment Fee 0.00 Spouse Information Name Albert Tessmann Address City, State, Zip Phone Next of Kin Information Name Relationship Address City, State, Zip Phone Lot 27.3 Name Henriette or Tessmann Comments/History Update Date 1024 1997 o? 7 3 PLACE OF DEATH STATE OF MINNESOTA County REGISTRAR'S No....__.._ OR v'uaOgeR- - - Permit for Burial or Removal City.... ................................................ Date of Death ........... Full Name/4—,-� 1#-- ... ! ....--- _ - ."ge .......... Sex........ 3.................Place of Birth... .................. Disease causing death... ?"'� - — �i­ i�,oi­ ­ * ­ * .... ..... . Medical cn/P4p`osed t attendantj� ..... .............burial or removal � ... S.. -,6-... 19. Place of 3(M-af�7 .. f ........ Place of removal .........................................via........ Undertake ................. .. ddress.. . A certificate of death having been file'office Minnesota, I herebyYO. _0,�ce with the laws of authorize the ........... 4 ................. ............... of the body (Burial or Re.,vp) of said deceased person as: stated above. In case, of death from a dangerous communicable disease, the burial or removal must be conducted according to the rules of the State and local board of health. ........ ..... ....... Dated ... F Official Title -Write "Burial" or "Removal"l" as th. ca,e maybe- ll Under- taker to the Sexton. Rernoval permits must be given Burial permits must be delivered by the Uadax- to the Agent of Transportation Company, and attached Z14Tto box containing body. Subregist,,rs viU write 'Sub" before the �.,dx "Registrar of Deaths" iocosv,l Elbsh,sr No. in, --w� . body for burial aithout ,be10w sinays giving No. of Licensc. Fine or, onprianounes, Received.... Name of Cemetery......... 19.... . , *.... ..............................Sexton ...................Address........................ NOTICE TO UNDERTAKERS This blank constitutes a Registrar's `Burial Permit" or "Removal Permit" according to the manner in which it is filled out by the Registrar. As a Registrar's Burial Permit, this blank most be obtained by the undertaker before any disposition is made of the body. It is th< duty of the undertaker to have a certificate of death properly filled out with the personal and statistical facts required by law, to present it to the attending physician for his certificate as to cause of death, and then to file the complete certificate of death with the Registrar of the district where the death occurred. It is illegal to bury a body in this state unless it is accompanied by a regular Burial or Removal Permit. As a Registrar's Removal Permit, this blank must be obtained from the Registrar, as stated above, Presented by the undertake ` to the Agent of the Transportation Com- pany, and be attached by the latter to the box containing the body. The Removal Permit is not a Transit Permit. The latter, supplied to embalmers by the State Board of Health, provides for a statement of the proper preparation of the body for transportation, signed al,e_rr...wla], Rwm:rat_n_m�.anin= a 9 Pro��a1_PPSmIt_ I�o Transit Permit can be issued by any Health Officer, or accepted by the .gent oof any Transportation Company in Minnesota unless a Registrar's Removal Permit forms part of it, or has pre" usly been issued by the registrar of deaths. ISSUE OF PERMITS BY SUB -REGISTRARS A licensed embalmer, holding an unrevoked certificate of authority from the State Board of Health to act as a sub -registrar of deaths, has the right to issue this permit to himself for burial or removal, under the same restrictions as those governing its issue b the local registrar, except in cities and villages which have a local ordinance requiring that all burial permits and removal permits be issued by the local registrar. The certificate of death, fully made out m ink, and signed by informant and physician, most be in sub - registrar's possession before he issues the burial or removal permit, and the death certifi- cate most be dehwered by the smb-registmr within five days to the local registrar of the district where the death occurred. The local registrar in a city is the health omcer; in a village, the recorder; in a township, the town clerk.