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Disposition PermitDISPOSITION PERMIT DECEDENT'S NAME PAULY, RONALD GEORGE SEX MALE DATE OF BIRTH/AGE 08/24/1938 / 73 DATE OF DEATH 09/07/2011 PLACE OF DEATH 7080 SHAWNEE LANE CHANHASSEN, CARVER, MINNESOTA FUNERAL DIRECTOR PAUL F HUBER FUNERAL HOME HUBER FUNERAL HOME & CREMATION SERVICE PLACE OF DISPOSITION CEMETERY PIONEER CEMETERY, MINNESOTA, CHANHASSEN 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 the State Registrar. Steve Elkins State Registrar DISPOSITION PERMIT ISSUED ON 09/07/2011 06:28 PM SIGNATURE OF CREMATORY OR CEMETERY OFFICIAL PRINT NAME OF CREMATORY OR CEMETERY OFFICIAL Form ID & Revision ID D104/ 12/ 2009