G  15685
PERMIT NUMBER
PERMIT FOR DISPOSITION OP HUMAN REMAINS
3C?7f<j/y]
NAME OF DECEDENT
Mrs, Maria Lee Hyun
PLACE OF DEATH—CITY OR TOWN
 Los Angeles
DATE OF BIRTH
Jiaiaj&L^jiiZZ.
PLACE OF DEATH—COUNTY (OR STATE IF NOT IN CALIFORNIA)
NAME OF FUNERAL DIRECTOR iOR PERSON ACTING AS SUCH)
Forest Lawn Hollywood Hills Mortuary-
Los Angeles
CALIFORNIA LICENSE NUMBER
F    90k
DATE OF DEATH
December 2.3,1968-M - 91
NAME AND ADDRESS OF SPOUSE OR OTHER INFORMANT
Peter Hyun
3367 3A Hamilton Way
Los Angeles,  California 90026
TYPE OF PERMIT. CIRCLE ONLY ONE OF THE FOLLOWING TYPES OF DISPOSITION
1. BURIAL (INCLUDES ENTOMBMENT)
2. CREMATION AND BURIAL  (INCLUDES INURNMENT)
3. CREMATION AND BURIAL AT SEA
4. CREMATION AND DISPOSITION OUTSIDE CORPORATE CITY
LIMITS. AND 01 HER THAN IN A CEMETERY. AS PROVIDED
IN HEALTH AND SAFETY CODE SECTIONS 7054.6 AND
10376(C).
5. SCIENTIFIC USE
6.  DISINTERMENT AND BURSAL  (INCLUDES ENTOMBMENT)
)
^   7.  DISINTERMENT. CREMATION. AND BURIAL
(INCLUDES INURNMENT)
8. DISINTERMENT.  CREMATION AND DISPOSITION OUTSIDE
CORPORATE CITi' LIMITS. AND OTHER THAN IN A
CEMETERY. AS PROVIDED IN HEALTH AND SAFETY CODE
SECTIONS 7054.6 AND 10376(C).
9. DISINTERMENT. CREMAT'ON. AND BURIAL AT SEA
10.  DISINTERMENT AND REINTERMENT OF CREMATED REMAINS
(INCLUDES INURNMENT)
II.  DISINTERMENT OF CREMATED REMAINS AND BURIAL AT SEA
12. DISINTERMENT OF CREMATED REMAINS AND DISPOSITION
OUTSIDE CORPORATE CITY LIMITS. AND OTHER THAN IN
A CEMETERY. AS PROVIDED IN HEALTH AND SAFETY CODE
SECTIONS 7054.6 AND 10376(C).
FOR THE PURPOSE OF ISSUING THIS PERMIT. DISINTERMENT IS DEFINED AS THE REMOVAL OF HUMAN REMAINS FROM ONE SPECIFIED PLACE OF DISPOSITION TO ANOTHER SPECIFIED PLACE
OF DISPOSITION   COMPLETE EACH ITEM REQUIRED FOR THE TYPE OF PERMIT SPECIFIED ABOVE AND ENTER "NOT APPLICABLE"  IN  EACH LINE NOT REQUIRED  FOR THE SPECIFIED DISPOSITION.
BURIAL
CREsHTlON
NAME AND ADDRESS OF CEMETERY WHERE REMAINS ARE TO BE INTERRED
HA
NAMh AND ADDRESS OF CREMATORY WHERE REMAINS ARE TO BE CREMATED
.  T        „        ♦   ,   "D   i   mfe.Glendale
ropest lawn memorial Park%xandale na.
NAME AND ADDRESS OF CEMETERY WHERE REMAINS ARE TO BlflNTERRED
Korean National Cemetry, Seoul, Korea
DATE CREMATED
JUL 24 v3T5
SlGNAIl%q|?eER50N IN CHARGE OF CREMATORY
Fbxfcbl   LA^^V'^nTlAL.PARK ASSOCT
INTERMENT
AFTER
CREMATION
MA
BURIAL AT
SEA AFTER
CREMATION
BOAT OR AIRCRAFT
NA.
BURIAL AT SEA
NOT LESS THAN
THREE MILES FROM:
NAME OF NEAREST POINT ON SHORELINE
j COUNTY
I
I
NA
DISPOSITION OUTSIDE
CORPORATE CITY
LIMITS. AND OTHER
THAN IN A CEMETERY
AS PROVIDED IN
HEALTH AND SAFETY
CODE
SECTIONS 7054.6
AND 10376(C).
DESCRIPTION AND ADDRESS SUFFICIENT TO IDENTIFY FINAL PUCE OF DISPOSITION
NA
NA
THIS IS TO CERTIFY THAT I AM THE PERSON HAVING THE RIGHT TO CONTROL THE DISPOSITION  OF THE
ACKNOWLEDGMENT   REMAINS OF THE ABOVE NAMED DECEDENT UNDER PROVISIONS  OF  HEALTH  AND  SAFETY  CODE  SECTION
OF
APPLICANT 7W0"  AN° l HERE8Y ACKNOWLEDGE THAT TRESPASS AND NUISANCE LAWS APPLY AND UNDERSTAND THAT
JJA THIS PERMIT GIVES NO RIGHT OF UNRESTRICTED ACCESS TO PROPERTY NOT OWNED BY ME.
SIGNATURE OF APPLICANT
^ NA
DATE SIGNED
NA
SCIENTIFIC
USE
NAME AND ADDRESS OF FACILITY RECEIVING REMAINS
NA
THIS PERMIT IS ISSUED IN ACCORDANCE WITH PROVISIONS OF THE CALIFORNIA
HEALTH AND SAFETY CODE AND IS THE AUTHORITY FOR THE DISPOSITION
SPECIFIED IN THIS PERMIT  _____ ^__
AMOUNT OF FEE PAID
2*00
DATE PERMIT ISSUED
UL 2 3 1975
jr*
>j
SIGNATURE OF PERSON IN CHARGE OF CEMETERY OR OTHER DISPOSITION
I CERTIFY THAT THE SPECIFIED DISPOSITION WAS MADE 0N_
(ENTER DATE!
COPY 1 OF THE PERMIT ACCOMPANIES THE REMAINS TO THE STATED PLACE 0^ DISPOSITION. THE PERSON IN CHARGE OF DISPOSITION IS RESPONSIBLE FOR COMPLETING THE PERMIT AND FORWARDING THF. COM
PLETED PERMIT WITHIN 10 DAYS TO THE LOCAL REGISTRAR OF THE DISTRICT IN WHICH DISPOSITION OCCURRED OR TO THE LOCAL REGISTRAR OF THE DISTRICT NEAREST THE POINT WHERE THE CREMATED HE-
MAINS WERE BURIEpjTJFA__ __^ -_ _--
COPY   1
STATE OF CALIFORNIA-DEPARTMENT OF HEALTH-OFFICE OF THE STATE REGISTRAR OF VITAL STATISTICS
(REV. 7-1-73)  FORM VS-9