Disposition Permit DISPOSITION PERMIT
DECEDENT'S NAME ETHEL MAE MAHONEY
GENDER FEMALE
DATE OF BIRTH /AGE 10/14/1932 / 87
DATE OF DEATH 03/22/2020
OLIVE BRANCH ESTATES
PLACE OF DEATH 1850 PIONEER TRAIL
CHANHASSEN, CARVER, MINNESOTA
FUNERAL DIRECTOR MATTHEW A HENDRICKSON M3151
BERTAS FUNERAL HOME & CREMATION / LIC # 0125
FUNERAL HOME OR 200 WEST THIRD STREET
OTHER ENTITY CHASKA MINNESOTA
PLACE OF DISPOSITION CEMETERY
PIONEER CEMETERY
CHANHASSEN CARVER MINNESOTA
MINNISOTA According to Minnesota Statutes, section 149A.93, subdivision 3,
MDHsection 144.221, and Minnesota Rules, part 4601.1500, the fact of
DEPARTMENT OfHEALTH death has been filed with the Office of Vital Records.
Molly Mulcahy Crawford
STATE REGISTRAR
DISPOSITION PERMIT ISSUE DATE 03/23/2020 01:24 PM
(SIGNATURE OF FINAL DISPOSITION FACILITY OFFICIAL)
41 k`r) . `-7k: t\/\) I S P n
(PRINT NAME OF FINAL DISPOSITION FACILITY OFFICIAL)
Rev 12/2013