Disposition PermitDISPOSITION PERMIT
DECEDENT'S NAME
GARY EUGENE CARLSON
GENDER
MALE
DATE OF BIRTH /AGE
04/23/1954 / 60
DATE OF DEATH
11/21/2014
MARIE STEINER KELTING HOSPICE HOME
PLACE OF DEATH
9120 SHADY OAK DRIVE
CHASKA, CARVER, MINNESOTA
FUNERAL DIRECTOR
PAUL F HUBER M2663
HUBER FUNERAL HOME & CREMATION / LIC # 0144
FUNERAL HOME OR
520 SECOND STREET
OTHER ENTITY
EXCELSIOR MINNESOTA
DISPOSITION FACILITY
FAIRVIEW CEMETERY ASSOCIATION
MINNETRISTA MINNESOTA
PLACE OF DISPOSITION
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.
U
Molly Mulcahy Crawford
STATE REGISTRAR
PERMIT ISSUE DATE 11/22/2014 07:10 PM
IGNATUR� OF FINAL DISPOSITION FACILITY OFFICIAL)
(PRINT NAME OF FINAL DISPOSITION FACILITY OFFICIAL)
Rev 12/2013