Burial PermitM
Burial - Removal - Transit Pemlit
NAME OF DECEASED
DATE OF DEATH
DEATH COMMUNICABLE?
Vicki Lynn Finley
February 4, 2004
❑m Q No
SER AGE
PLACE OF DEATH R1n,YLlAea oA Towwa�I
NbIAMTY)
Female 1 56
Chanhassen
Carver
MEfiIOD OF pSPOSAI
PLACE OF DISPOSITION (MIME OP CEMETERY OR CREMATORY) (CITY, VILLAGE OR TOWNSHIP, COUNTY. STATE(
aBURIAL ❑CREMATION
Chanhassen Pioneer Cemetery
❑REMOVAL OTHERIRmM
Chanhassen, Carver ,MN
SIONAr OF TICWI OR FUNERAL qMeCTOR
BUSINESS ADDRESS
16394 Glory Lane Eden Prairie MN
55344-
4 cPrtifl of death having
filed as required by law, permission is hereby given to dispose of this body.
E MIS ^
RM,VILIACEoR MOUNT"
ITITUP
DATE ISSUED
den Prairie Hennepin
Sub -Registrar
2/5/2004
SIGNATURE W PERSON IN CHARGE OF CO1=E
AUTHOR® DISPOSITION
SIOW OF CEMETERY
DATE RECEIVED
AS STATED ABOVE
Feb 7, 2004
-
OCCURRED ON:MATM
HE -00113-03 (7/94) v J OrIginal-p(ice of DMPDS Don Copy -Sub Regadrel