Disposition Permit05/10/2017 09:14 9524741178 HUBER FUNERALHOMES
DISPOSITION PERMIT
PAGE 01/01
DECEDENT'S NAME
GERALDINE JEANETTE PAUL.Y
GENDER
FEMALE
DATE OF BIRTH /AGE
11/08/1938 178
DATE OF DEATH
04/18/2017
RESIDENCE
7080 SHAWNEE LANE
PLACE OF DEATH
CHANHASSEN, CARVER, MINNESOTA
FUNERAL DIRECTOR
PAUL F HUBER M2663
HUBER FUNERAL HOME & CREMATION / LIC # 0914
FUNERAL HOME OR
16394 GLORY LANE
OTHER ENTITY
EDEN PRAIRIE MINNESOTA
DISPOSITION FACILITY
(crartmTZON)
FAIRVIEW CEMETERY ASSOCIATION
MINNETRISTA MINNESOTA
PLACE OF DISPOSITION
CEMETERY
(uex BURIAL)
CNANHASSEN PIONEER CENRMRY
CHANHASSEN CARVER MINNESOTA
According t0 Minnesota Statutes, Sec"u"
section 144.221, and Minnesota Rules, part 4601.1500, the fact of
death has been filed with the Office of Vital Records.
0)0�4
Molly Mulcahy Crawford
STATE REGISTRAR
DISPOSITION PERMIT ISSUE DATE 04/19/2017 11:22 AM
(SIG ATURE OF FINAL DI OSI ION FACILITY OFFICIAL)
(PRINT NAME OF FINAL DISPOSITIO FACII-IfY OFFICIAL)
Rev 12!2013
!7