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Home My WebLink About3-COL-46DnBName_,.Zc,f% SFV C A//2i55 t�Earl+�iNS ,✓�% 1 1i�5 Unit 3 Block �al' Lot Date of Mark -out + / Date of Burial "1122 Al S^ • Time Name of Funeral Hom Authorized by Certificate No. 2456 CIS OF SEBASTIAN Certificate of Interment Rights IN ACCORDANCE with provisions of the Code of Ordinances of the City of Sebastian, it is hereby certified that: Linda Sevenliss 317 Sea Grape Avenue Sebastian, FL 32958 In and for consideration of the sum of $2,000.00 is entitled to full interment rights in the Sebastian Municipal Cemetery for the following niche: Unit 3, Columbarium, Niche 46dnb of the Sebastian Municipal Cemetery, as maintained on file in the records of the City Clerk for use in accordance with the conditions, ordinances, resolutions, rules and regulations prescribed therefore by the City of Sebastian. CONVEYED THIS 13th day of April, 2015. CITY OF SEBASTIAN, FLORIDA y1� Joseph F. Griffin City Manager ATTEST: Sally A. Maio, MMC City Clerk from SEAWINDS CREMATORY Sebastian, Florida 1W 735 Fleming Street • Sebastian, Florida 32958 www.seawindsfli.com (772) 589-1933 We hereby certify that these are the remains of JOHN GARY SEVENLISS it s!Ffi ?e? . The remains were received SEAWINDS FUNERAL HOME & CREMATORY Cremation Permit No. 15-73380-5106 Issued at Date of Death APRIL 17, 2015 INDIAN RIVER COUNTY Date of Cremation 1 ^ a 3 By 4! t Cremator CITY OF SEBASTIAN FINANCE DEPARTMENT RECEIPT 9894 Name /U ✓id t sey 11� ❑ Cash ' p Date `'T 7' i� UjGheck # ❑ Credit Amount Paid 001001 208001 Sales Tax 001001 220000 Security Deposit - 001501 362100 Taxable Rent - 001501 362150 Non -Taxable Rent - 450010 369900 Airport Badge 001501 329500 Alarm Permits 001001 218010 CobraServe 001501 354100 Code Enforcement Fines 001501 347557 Community Center Revenue 001501341920 Copies 001501 369900 Miscellaneous Revenue 001501 359000 Other Fines/Forfeitures 001501 351140 Parking Citation 001501 342100 Police Security Services su3 plc, D UU Total Paid 6o, o 0 Initials White - Dept. of Origin • Yellow - Finance • Pink - Applicant FUNERM711 ADDRESS: PHONE #: FUNERAL DIRECTOR'S REQUEST TO CITY OF SEBASTIAN FOR BURIAL OPENING IN SEBASTIAN MUNICIPAL CEMETERY SEBMT wua ruKn nano For information contact: Kip Kelso • Cemetery Sexton Sebastian Municipal Cemetery (772) 589-2545 City Clerk's Office City Hall, 1225 Main Street Sebastian, FL 32958 Office (772) 398-8215 or 388.8214 Fax: (772) 589-5570 (Check One) _OPEN BURIAL LOT Lot Block Unit OPEN CREMAINS LOT Lot 81ock Unit #OPEN COLUMBARIUM NICHE Niche4Z Block .off Unit 07,v76. / W BURIAL DATE AND SERVICE TIME: r��' �� /l'oo/e(��d✓�S p�� FORDECEASED: SohriJ- 52l/1kLr55 rvame NAME AND SIGNATURE OF LOT OWNER OR REPRESENTATIVE: (Must provide proper documentation of ownership) Name Signature Date I certify that I have determined the ownership of the above described site that all site fees and administrative fees have been paid and authorize opening of same NAME AND SIGNATURE OF LICENSED FUNERAL DIRECTOR. N�lf Name 'Signature Dale Cemetery Sexton Certification: 1 certify that I have checked the ownership information by viewing the owner's deed and confirming with Clerk's office and that all fees have been paid cernotery 9 xion Date This form to be provided to Clerk's Office by Sexton for permanent record upon completion. JOHN GARY SEVENLISS April 16, 1940 -April 17, 2015 John Gary Sevenliss of Sebastian, passed away April 17, 2015 peacefully in his sleep at home. Beloved husband of Linda 53 years, Loving father of Robyn Durkin and husband Marty of Sebastian, Dawn Foley and husband Matt of Calverton, N.Y. Cherished grandfather of Chris (Krissie) Durkin, Jim (Jamie) Durkin, Brittany Durkin (Frank), Brandon Foley, and Ryan Foley. Loving Brother of Gordon & Craig and many nieces and nephews. Retired Navy Veteran, Retired Suffolk County New York Police Dept. Member of Italian American Club, Elks Lodge, both Sebastian, and the International Police Assn. CITY OF SEBASTIAN FINANCE DEPARTMENT RECEIPT 1889 '�16L Name � L) Cash _ Date/!✓?�� j:neck#S-Q ❑ Credit Amount Paid 001001 208001 Sales Tax 001001 220000 Security Deposit - 001501 362100 Taxable Rent - 001501 362150 Non -Taxable Rent - 450010 369900 Airport Badge 001501 329500 Alarm Permits 001001 218010 CobraServe 001501 354100 Code Enforcement Fines 001501 347557 Community Center Revenue 001501341920 Copies 001501 369900 Miscellaneous Revenue 001501 359000 Other Fines/Forfeitures 001501 351140 Parking Citation 001501 342100 Police Security Services 0/0 se/nad 16teAAide— G}5/5Q/3f�38Q�f�/ p&ne- �f Total Paid�� (J�r�itials White - Dept. of Origin - Yellow - Finance • Pink - Applicant arc oa SEsASTL y:. HOME OF PELICAN ISLAND City of Sebastian Municipal Cemetery Purchase Receipt To enable the City of Sebastian to determine the correct rate, and in accordance with cemetery rate regulations, proof of City residency of purc aser or person for whom lot is intended for interment must be provided at timof purchase _�W15S Name(s) Address %%Z, 39f -0-7S46 Area Code & Phone Number Name & Residence Address of Receipt is acknowledged in the sum of: Than Purchaser OFFICE USE ONLY ($ a?000po on this X3 '�4- day of 20 1,15' for the purchase of the following described Cemetery Lot(s) and/or Niches . Unit , Block , Lot(s) Niche(s) V �Oo hw-& tU� for use in accordance with the conditions, ordinances, resolutions, rules and regulations prescribed therefore by the City of Sebastian. Additional Fees paid at time of purchase: Corner Markers (set of 4 - $20) Opening & Closing Vase and Ring for Niches (cost) O 7• Z� Interment _ Temporary Marker Preparation & Installation Signature o Purchaser I:\W W-DATA\Ms-Cemetery\RECEIPT.doc /W O H Circle One Disinterment TOTAL (OW Z� City o Seb tian The following documents were provided as Proof of Residency: and