Disposition Permit DISPOSITION PERMIT
DECEDENT'S NAME ELMER FRED LEHRKE
RECEIVED
AUG 5 201
GENDER MALE Pry OF
DATE OF BIRTH /AGE 04/15/1926 / 93 CI�ANHASSEN
DATE OF DEATH 06/22/2019
GOOD SAMARITAN SOCIETY WACONIA
PLACE OF DEATH 333 W 5TH STREET
WACONIA, CARVER, MINNESOTA
FUNERAL DIRECTOR TODD A JOHNSON M3095
JOHNSON FUNERAL HOME / LIC # 0141
FUNERAL HOME OR 141 EAST FIRST STREET
OTHER ENTITY WACONIA MINNESOTA
PLACE OF DISPOSITION CEMETERY
PIONEER CEMETERY
CHANHASSEN CARVER MINNESOTA
M I M M E S 0 T l According to Minnesota Statutes, section 149A.93, subdivision 3,
section 144.221, and Minnesota Rules, part 4601.1500, the fact of
DEPARTMENT orHEALTH death has been filed with the Office of Vital Records.
Agbit))1•41 Ilia
Molly Mulcahy Crawford
STATE REGISTRAR
DISPOSITION PERMIT ISSUE DATE 08/01/2019 03:56 PM
(SIG T� URE OF FINAL D ITION FACILITY OFFICIAL)
w-1 " H e ,t W t:5 Se r C-C-PrP_ kka..Arkle r Iblz]pu..4-ci Cier-1 .
(PRINT NAME OF FINAL DISPOSITION FACILITY OFFICIAL)
Rev 12/2013