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Disposition PermitDISPOSITION PERMIT DECEDENT'S NAME JOHN THOMAS FRASER SR. GENDER MALE DATE OF BIRTH /AGE 07/25/1938 / 77 DATE OF DEATH 09/04/2015 AUBURN MANOR PLACE OF DEATH 501 OAK STREET CHASKA, CARVER, MINNESOTA FUNERAL DIRECTOR TODD E SULLWOLD M3106 BERTAS FUNERAL HOME & CREMATION / LIC # 0125 FUNERAL HOME OR 200 WEST THIRD STREET OTHER ENTITY CHASKA MINNESOTA PLACE OF DISPOSITION CEMETERY 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. dbt ° U Molly Mulcahy Crawford STATE REGISTRAR DISPOSITION PERMIT ISSUE DATE 09/04/2015 04:18 PM (SIGNATURE OF FINAL DISPOSITION FACILITY OFFICIAL) (PRINT NAME OF FINAL DISPOSITION FACILITY OFFICIAL) Rev 12/2013