Disposition PermitPLACE OF DISPOSITION
PIONEER CEMETERY
CARVER MINNESOTA
m "--" s °- T ` Am
RECEIVED
,f
sect
ISPOSITION PERMIT FEB 0 3 2017
DECEDENT'S NAME CH
RLES ALFRED ROBINSON CITY OF +'MANHASSE
AKj
/ CHARLES A ROBINSON
GENDER MA
.E
DATE OF BIRTH /AGE
11/15/1928
/ 88
DATE OF DEATH
011:1/2017
(TION FACILITY OFFICIAL)
RE
IDENCE
PLACE OF DEATH
79
TIMBER LAKE DR
ED
N PRAIRIE, HENNEPIN, MINNESOTA
I
FUNERAL DIRECTOR
AM
C TRICK M4075
HU
ER FUNERAL HOME & CREMATION / LIC # 0914
FUNERAL EOR
16
4 GLORY LANE
OTHER ENTITY
ED
N PRAIRIE MINNESOTA
PLACE OF DISPOSITION
PIONEER CEMETERY
CARVER MINNESOTA
m "--" s °- T ` Am
rding to Minnesota Statutes, section 149A.93, subdivision 3,
,f
sect
n 144.221, and Minnesota Rules, part 4601.1500, the fact of
'otneTeexsa,di.«« deal
Vital Records.
has been filed with the Offic/e.
/of
Molly Mulcahy Crawford
STATE REGISTRAR
DISPOSITION PERMIT ISSUE
[ATE 02/01/2017 01:57 PM
(SIGNATURE OF FINAL DISPC
(TION FACILITY OFFICIAL)
(PRINT NAME OF FINAL
FACILITY OFFICIAL)
Rev 12/2013