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Disposition PermitDISPOSITION PERMIT DECEDENT'S NAME DANIEL JASON ROBINSON AKA / DAN J ROBINSON GENDER MALE DATE OF BIRTH /AGE 05/23/1969 / 44 DATE OF DEATH 02/14/2014 METHODIST HOSPITAL 6500 EXCELSIOR BLVD PO BOX 650 PLACE OF DEATH SAINT LOUIS PARK, HENNEPIN, MINNESOTA FUNERAL DIRECTOR CHARLES B WILLARD M3572 HUBER FUNERAL HOME & CREMATION / LIC # 0914 FUNERAL HOME OR 16394 GLORY LANE OTHER ENTITY EDEN PRAIRIE MINNESOTA DISPOSITION FACILITY FAIRVIEW CEMETERY ASSOCIATION MOUND 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. Heidi Granlund ACTING STATE REGISTRAR DISPOSITION PERMIT ISSUE DATE 02/16/2014 12:39 PM (SIGNATURE OF FINAL DISPOSITION FACILITY OFFICIAL) (PRINT NAME OF FINAL DISPOSITION FACILITY OFFICIAL) Rev 12/2013