Burial PermitSTATE OF MINNESOTA
DEPARTMENT OF HEALTH
Section of Vital Statistics Registration
Burial - Removal -Transit Permit
NAYS OF DECEASED
Anders Wilbert Anderson
SEXMale179EYears
METHOD OF DISPOSAL:
Cl BURIAL El CRENATION
7 REMOVAL ❑ OTHER (.Dedfy)
BIO OF MORTICIAN OH FUNERAL DIRECTOR BUSINESS ADDE888
T. /� 520• -2nd. St., fixcelsior, Minn.
A eerdfiwte of death havtn, been filed .o "eird by law. Ferulffbn b hereby sisee to dbFew of thl. beds.
816 OF REGISTRAR (city. vulg. er Tows") (Ceuq) DATE ISSUED
/�,y..� Excelsior Hennepin I 11 -26-1274
DATE OF DEATH DEATH
Nov. 229 1974
PLACE OF DEATH (CHs vul... or Town hie)
St. Louis Park
PLACE OF DISPOSITION (Nw of ea -.ter, or As tory) (CH ,
Chanhassen Twp. Cemetery
Permit No
J Yee I al No
C
(e.ty) L7
ey Tow=Up, Ce®ty. Stew
Carver Cty, Minn.
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