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HomeMy WebLinkAbout0976 - ~ ~~t)'9• ~ ~ ~ _ Gl l~~ ~ J r~ c~.~ ~ OA11 Nli.~cIFHLUPY 51:.11 H~~. ~ . STATE OF COLORADO CERTIFICATE OF DEATH (PMVSICIAN OR CORONE R) $IATE (It/ ~:i.L1MfH (1f[EACEO NAM( ~~~~.r 4~co.1 ~~N OEIMTtIE1rt Sfx OAi[Of DEA1N ~w~.~- i.~, , Lee Nubert Peck ,Male , Juiy 26, 1985 f~. q4Cf ~ww~.Yr~ ONiWNORptSCENi AGE - tai~ T ~r.D~w ~ v~~w 4')IN ~O~• 041E O~ O~AiN GOUN7t O! UF.~/N n.sa~ ~....rr.~.+~K~ ~.w ~r..~•, tyr Y~r~O~•i~w. ~.oi t~~rs He r.tie •wy.r.. DA~,~IIAI Whi te :Ameri can 90 ~ S_~,~" l- .Dec . 30 1894 3ou1 der__ ~~1Y TC~~'~ORl9CA71pryQf OEAiH HOSF11A1 GPO~NfN~NSTrtU11ON w.....,~...,s... ` Y)E KAQI Nr( - v~ u.w~ w~.wr~~ 1~ NOSP OF IS~7 M MM11TE71 ~r t ~ F. ~ . . ~ . ~^TM~~ Bo id r . Bou~der ~4anor M.~., ~ - =In atient - .wy~+ Q~~:.TS C~ ~~i1N~:~....~uS? UT~ZCNO~ rY~~ATCOuAIwI ( ~•:.aaeED ~.IV[pf~wqw~FO. SuqY~:~r~GSr'O~tSF•.•+:. e..~-.,....,.,...~ ~Y.tiSnfGEDV~• t•_' . ~ Y. ~KkP OCIOR' p ~y~....~.• AR4tf0 ~RCE~. ~ Ohio , U.S.A. ~.f~arrie _1„Ciara M. Lewis ~es N,^~M~ 1r . _ " n 0 •.,-'~tSICUH!)~Nl~1~BFR USJaIACCU~AT1pN•4.....i„•,,,.•...c'-a.~.+.:ti•c•.,~.~ KiADOiBUS~!1FSSOR.tipv$~RV ~ W`~• „ 274-20-655~ •..yice Pres.R%Treasurer ,dndustrial Machine Ca. _.~.,~..o. - hkS'G[NCE S7AlE CWNiv C~iY.TOWkONIOCAT~ON l+P STR(fTAN~JNUMlER r . .~roe¦c~ . ~,.Colorado ,~.Boulder .s Boulder 80301 ~~.6240 Willow Lane ~,:Yes__ iAlNLp-NM1f ~~ns~ v~~~,i i•S~ yOIHFN-NA4f r~eS~ v.un.r ~a.~.•._, Hubert Peck „ Unknown 1•;fpR~1AYT-l+~Vf •oh~.w.-~ 4QItINGADOAESSS+~+tF~MwfOtiO C~~~Oa•~M? ati.~E ~ . C7ara Peck Wife ,~~6240 Willow tane Boulder,CO 80301 ; Z 6~..P~At CRE~lAltpf~. RFR.UY4i G~'E 'Vye+ D,. r..-~ Cf VE lE Rr pp CRfYAiONY -NAME AhD IOCAT~Oh e~e. p.~ rnw? 1-:.•• ' Cremation ,~7-27-85 ,L Oenver Crematory Lakewood Colorado N _ g o~~e:«a ,~nECiOR r:Af1C AHOnOORESSOF FUNEHAI wpMf .si~:,~q.p~ o a^ S~~'~ 3~ o;"" owe Mortuary 2121 llth St.,Boulder,C080302 ~ Yt~t1AN J~ 0/1 72• CORONER - CM~ ~w[ ~aS~t Os F=~~a.~~f~OV ~~O D° 3-_. ~OThftlS~O~~~K+.ON~CLL[O(~1r.pC(vanEplr~~vOriwFOME~40?lAtf WvfS7~~1.p~y~qurphv~6rDE~*~JCC~.F-~O~• . •~LOUf~OtwECwy~y~K ~~Ei ' dYIMED~TkANO?~a~E~+.COl:E7C'~EC~VSt~YS•«[D Q / i ~ W Sa :t~. , l~ c' ! / ` ~~~,f'~ ~i,~,.~~.••-er.o~r ~ OwTE SIGNED u~Lwsr~ Dn ~ ~ OATE S~G~:EO Mwr u~ rw+ ~ vqp•.C~ F~ pE AO v. c. ~ 2 ` J_ ' 1i - U ' ~ ~ 'J ` _,i q4VERMDApOpE550~CER7~FiEa/DNVy~C~atiCFCORJ'•EA o~?~-*• ~ " Dr. Thomas Hig,g~ns ~ 2~0 Broadw~y Boulder, CO 80302 ^ .c[~~qirAR ~ iL~TtRFIf~.EI•4 4~ ~'_~iP:.S.vr-.'.. / e _ / 1 ~ 1l' yL- ?ANT ;E41Ep0[~. QHEC4U$E VERI~NE iOR4 te~ r+t.n' ~ • . , + iti•vEO~RTE C~~SE ~ ~ ~ . . L- I ( - ~ ' . ' ` DUE 10. pP. ~5 A CU\SEOUE'.CE QF ~ ~ - ~ - _ti~ _ - . - - . ~ . . i . . ' ~ , / J - - - - ' - ' ' ~ , 1 _ ' ~ ' Ml~ TO O~t 45 A CC'.SEOJENiE pF ~ ' ' ' - ' - - ~ W ' ' ~ , ~ ~ . r t 7 u - - - ' - 1 _ . . ' O '-~~OIR7 OTHESS~GhIF~~A~ICUhD~T1O'.S-'.ov - . - ^:mW~•~w~~w•.r.e+~r.,~.~.. •ra.~..`~~ .a~i{(~o~- ~'1 , ~ - ' ~ f:s ~Q TC 1'Q ' ~ G _ _ . _ _ U Rff~~EHT,SU~i-'OE. ~t0'•11CtDE. ~~D~~C .a1~ H7ua O~ ~NJ;R\ (~ES~,RtFE N!?f5 ~~IT Nl Q{'CUFREC~ „•:DS'Enw•:'_C.?f~0+itc3 ~~:tiESr~:.~t~OV : a•. - I~~~ , 1._=_ ' ' _ ' 47 ; ~R ~ :._E Di .JI~R? - IOCAT~ON 5'Af F t Oa w ~ C A~ . Go'OA\ S'~T~~ ~ _ " _ _ " _ _ " _ _ " _ " " . a eo. - ,1 7a. STATE OF COLORADO, CITY q~D`- COUi~FY Of. BOULDER I hereb,y certi fy that t.he;: abo~r a• ~t~ti~, ful i and correct copy of the certificate in my custq~j~c' anc~,~~~=on fi~e in my office as required by law. . . r~;..~.+1 _ ; ~ i ~i . ; _ ~ iJi tness my hand and offi:~ta~'l;~s ~\a~ Bfbul der i n sai d State, thi s . date . _ ~=~,r.~ ~ -~~~~~Jt,~ ;~l'. Donnel ly, M. D. , Oi rector Not vatid without IFegistrar of Yital Statistics locai reaistrar's City and County of Boulder, Coiorado seal. ( ? ~;1~ `//~~~j p~puty ~86 `~1 l9 P2 ~~0 '7!~~~v~~1 f ~ ROGck r;;+;,_ ' ST. LUCt~ CO:~!;-';; `~r,.,6 ~t - ~~4 ~ t ~J`•~ ~ - - . _ . . ~ R- . ~ ,