Disposition PermitDISPOSITION PERMIT
DECEDENT'S NAME
TODD ERIC KEMPFERT
GENDER
MALE
DATE OF BIRTH /AGE
07/09/1967 /51
DATE OF DEATH
10/04/2018 (DATE FOUND)
FUNERAL DIRECTOR
SCOTT W WALZ M3935
WASHBURN-MC REAVY EDEN PRAIRIE CHAPEL / LIC # 0956
FUNERAL HOME OR
7625 MITCHELL ROAD
OTHER ENTITY
EDEN PRAIRIE MINNESOTA
PLACE OF DISPOSITION
CEMETERY
PIONEER CEMETERY
CHANHASSEN CARVER MINNESOTA
4 I x " t o-r_a According to Minnesota Statutes, section 149A.93, subdivision 3,
section 144.221, and Minnesota Rules, part 4601.1500, the fact of
GFAAYTSFtlTOl fiFAITN death has been filed with the Office of Vital Records.
Molly Mulcahy Crawford
STATE REGISTRAR
ITION PERMIT ISSUE DATE 10/08/2018 03:40 PM
OF
ON FACILITY OFFICIAL)
(PRINT NAME OF FINAL DISPOSITION FACILITY OFFICIAL)
Rev 12/2013