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HomeMy WebLinkAbout2989 ' ~ ~ fIlEO AMD RECOR E " ~Q~~ sr. ~uc~ cau~rY ~~~i. AQG~n i i~TRAS ClfRlc C?~CUIT COUIlT IIECORO vERIFiEO~ 9 12 49 PH'1! rn?. s.- sirwT~ ~owwo o~ Nw~TM Cr.RTlF1CATE OF DEAT~ • •uecwv oR v~w~ ~rwnn~c~ fYAT[ FIL[ N0. ~•t•l FLOBIDA •rd •\~w et TH NO. R G16TRAR•S HO. I~ ~r~p~rl~ 1. KwCS 01 ~tATN GOOC NO. t YMA~ wtflotNC~l~~w.~nr..~r.t q:.w.www f...b.r~...i.w...) ~ e ~ t~ ~ ODIM?r a tTATC ~ OOYMTY •d ~t11 ~ Florida S~. T - , . ..ucie 1~ P~f- C1T1/. T01rM.ORIOCATIOM t. 15 IUCE Oi OfATM CITY. TO~flt.0~ LDCATIOM t. IS RES1DE1iCE INS10E CITr UY17S7 17KIDE CITY UYITSI rii.. g Ycsp wLY F resQ w? j. lIAME Of (j(1M i~ ~M~if~. /rt IbMf 1/4Y1) IEMGTM Of I. STIIEET A~ESS OII A iA11Y/ ~ StAY i11 N ~ _ 7 ? NO s. w?~ er Fr..r uwr. t.r a. wTC u..n nn r~.. i~,.«;:~.r~ ~ d °~?TN D 6 S. S~X COIDA OA RACE MAww1ED ? MEY(R YMAI[O 1. DATE OF WTN ! AGE U~ tea~ i 1/~0[t 1 ~W W[~ N MRS ~/1 Mw~Y~ D~y~ Yw.~ 1fi~. r" x rmoorcop avaeac Se L 1 r 1~1 ~ 1> >a. uw~ occw~noN ~o~ y.«~ s... la- K~MOOf ~iJSUI[SSOA INDUSTRY 11. NIITMKACi (3~ft M~~ pY~l?/1 1 CR1a'M OI nMi QOIIM7RT~ • l t~ Isriy ~wt y Mrli~I bk. wn V~~wM ¦••'•s L ~ H ' e U$A ll~~k f~l[ li fATK11'i w~Wt 1{. YOTMER'S w~0E11 wI1rE en..r~a.r Jp : B 1 D yi is_ .ns aa.sco cvcs w u. n urco sw~ccv u socuLL scwa~~ wo. i~. w ~ N~w?Twc ,josie Bell Davis 3ofle5 ~ • c?.........~wd W....w.......rrJ..w - ~FF_/,.'~_!,~K wu•••• i, V S F P' e:~ce F'la. /~~~r~l 1{. iAYK K KATII (blfrr wtI ~ nw pa Jrae /r ta). (0). ~st (c).) UcTEnv~l KTwEtK ~ 1 t~ C t~• /AIIT l OEATN MAS CAYStO OMSET A110 OEATN IMtl[ONT[ GWSE (~J + r~ i i •~~t !~l• . ~ t~• c~r- U tl e~ t• C~wIY~w. p/. OY[ TO l~) : •lt\ t\• ~ry~ ~ ~ 1• e~ 1 ~D~rr cwe (i~ • j r~ai~srsr ~~~~nue~ t~' oK TO (d ~ .fteu » = w•s~usovsr ~ \~~It• •f- O ~MT N. OTIt1 WrAfiGlff CO~ptIb~S (,pNiWyfwG 70 OU1fw i~li NpT RE~A7[O i0 TM[ iLirrMl pSGSE CO~pTqlf Gill[A M~YT 1(t) ~~~~D1 r ~ a~r a•~c~ ~ res? uo0 •r ?~f~r• 1 mp aKp+~ ~ My~~r OCC~a~EO (Sda ~~hut ~Jn~/wr/ iw Prt !~r P~rt )I ~l iaa /~J •~tl~a ~ ~CCWfMT SUKIOE NOMKeOi ~ ~ O O Car tzr:zad over ia ditch •r ~ m[ t~~tE O~ H... x«n. nn. ~.o uuu~r ~ S ~ ' I 20/. ~NlYA~ OCCYIU[O mt. ?I~CE Oi ~wJ~11v <e. ot a a'~a.t bv. mI. GTY. TOi1fM. OA LOGT1011 OOYMTr STATE Y(NK[ AT ~ IqT 1IIMKE /~al. Yrrtt. oQict OII/.. dt.) *~K .?.b+~K I~: - Ft rierce St. L;;cie clorida 2t. /~fNwd~I tMI~oMMI/ m~i . fo ~G~~~~]~ •ndluf w~ Aj~s~ .s..on lav~r C2F_ri ' DtitA aeeurnd ~t K•~•• m on tM d~t~ u~t~d ~Dov~: ~nd ~o rM Mat o/ aq ~ew~.Nd/~. I~orn d.~ uuNS ~br~d. ?11 lt~~• ~ sICMATY~f t• ~~i~uM:4p) Coroner ~ ~~EU - ~TES'~.KO • ~ J.P. Lz r r'erce Floriaa ~2 i3 62 •~tY~~t~. ~~W. ~y~iplt j]S pAT[ 27f NAME O~ C[Y[TEIIY u71 CR[MATQ!!Y j]/. IOCATIOM (CY~.llri. M tM~) 11[rOrK l8yr[~//1 , , • ~ ~~:^ete. FL. Pierce Florida ~ f A 17 2~. NK~IAI E Ow "S SKM~TYRE AD011(SS 2S. pATE RECD. ~Y IOC~I ~[G. ~EG6T~Al1'S SIGMATY1lE a...~ass T F i_2~-6 :.nna Lee Deniso.^. d.r ~ t ~ a ! h~rol~? oxttfy thls to b~ • true ~nd c~rut copy vF tl~e loanl Repist~rara record on fil~ i~ th~ St. tuct~ County Heattfi D~-~orl• ~ rrrnt ~t Fort PiKte. Plorld~. ~ r+•k ~ (Warnin~: Not valid unless raised ~al of the St. Luc1s '~~r'~`~'%~~. ~ Counry Hwhh D~p~~tmsnt is affixed.) ~+i~ -'s• , ~ r~? ~ ~ ~ ~ ~ N. M1LLER, M. 0. " • . ~ ' County H~aith Officar d~ Lxs1 Ra~i:tru ~ . ~~z { . ~ _ ' : ~ . . :~r . ~ . ~ ~ ~ ~ QOw D~{Ilti/ L06tI ROQiS1~0/ ~ ~ , - , ~ AZ! 1~~~,~ ~ ~ ~ ~ ~•~~,~i~i~~ ~ ~~192 2983 ~ . ~ z: . _ _ _ . _ -