HomeMy WebLinkAbout3-COL-38SnCertificate No. 2488
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:
Mary G. Romagna
442 Pine Street
Sebastian, FL 32958
In and for consideration of the sum of $1,200.00 is entitled to full interment
rights in the Sebastian Municipal Cemetery for the following niche:
Unit 3, Columbarium, Niche 38sn
of the Sebastian Municipal Cemetery,
as maintained on file in the records of the City Clerk
for use in accordance with the conditions, ordinances, resolutions, rules and
regulations prescribed therefore by the City of Sebastian.
CONVEYED THIS 13th day of January, 2016.
CITY OF SEBASTIAN, FLORIDA
Joseph F. Griffin
City Manager
ATTEST:
Sally A aio, MMC
City Clerk
an of
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HOME OF PELICAN ISLAND
City of Sebastian Municipal Cemetery Purchase Receipt
To enable the City of Sebastian to determine the correct rate, and in accordance with cemetery rate
regulations, proof of City residency of purchaser or person for whom lot is intended for interment must
be provided at time of purchase.
O -X -(A G.
Name(s)
Address
L-/ - .
Area Code & P
i n e Sfreef
388 - OZ
Number
Seb6LS f f&n F& 32959
Name & Kesldence Address of Intended Occupant if Other Than Purchaser
Receipt is acknowledged in the sum of:
on this day of
Cemetery Lot(s) and/or Niche(s).
Unit , , Block , Lot(s)
OFFICE USE ONLY
Q% -.-
I/,Lrhq AddrceSS
Dollars ($ /ZOO. )
, 20 16 for the purchase of the following described
Niche(s) 3Ss n
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)
Temporary Marker Preparation & Installation
Signature of Purchaser
I:1W W-DATA\Ms-Cemetery\RECEI PT.doc
Interment
/W O H
Circle One
Disinterment
TOTAL $ 1200, 0 0
�,���t_lt,nzQ
4ity of Sebastian
The following documents were provided as Proof of
Residency:
and
CITY OF SEBASTIAN
FINANCE DEPARTMENT RECEIPT 9971
Name MGary !2o i I'1GfG/ n Q ❑ Cash
Date — �J� �o [(Check #
❑ 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
001001218010 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
6,0101 a 39, �ROO Cera, Lot
U 3 & 1 3,Rsn
Total Paid I oZX• 00
Initials
White - Dept. of Origin • Yellow - Finance • Pink - Applicant