HomeMy WebLinkAbout4-03-38arr 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 purse se
Name(s) 7�lO
Address
-272 5r/ S'7/L1
Area Code & Phone Number
Name & Residence Address of Intended Occupant if Other Than Purchaser
OFFICE USE ONLY
Receipt is acknowledged in the sum of:
0Aj& �� A-rvD A-r�'d � �A D D Dollars ($ I, 0 oo `� )
on this z31 57- day of `%� 20 1.6 for the purchase of the following described
Cemetery Lot(s) and/or Niche(s).
Unit 4 , Block 3 , Lot(s) .32 Niche(s)
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
g ature of Pu c aser
I:\W W-DATA\Ms-Cemetery\RECEIPT.doc
Interment
/W O H
Circle One
Disinterment
TOTAL $ 41000 . O a
City of Sebastian
The following documents were provided as Proof of
Residency:
Tt:l
CITY OF SEBASTIAN 10092
ADMINISTRATIVE SERVICES RECEIPT
Name %/ C IA— ❑Cash
Date 031 J 1c, U6fieck #
O Credit
Amount Paid
001001 208001 Sales Tax
001001 220000 Security Deposit
001501 362100 Taxable Rent
001501 362150 Non -Taxable Rent
450010 369900 Airport Badge
001001218010 CobraServe
001501 354100 Code Enforcement Fines
001501 347557 Community Center Revenue
001501341920 Copies
001501 351140 Parking Citation
001501 342100 Police Security Services
001501 329200 Site Plan Review
001501 329300 Subdivision/Plat Review
001501 329100 Zoning Fees
De 1 s ol 3'�� SCIc �/yop. od
U -'i 3uC 3 LOT 38
U Total Paid I X00'
itials
Security Dep Held - Amount $ Check #
White - Dept. of Origin • Yellow - Admin. Svcs. • Pink - Applicant
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SEBASTIAN
HOME OF PELICAN ISLAND
1225 Main Street
Sebastian, FL 32958
(772) 589-5330 Phone
(772) 589-5570 Fax
June 2, 2016
Richard and Judith Kicia
466 Autumn Terrace
Sebastian, FL 32958
RE: Interment Rights to Unit 4, Block 3, Lot 38 Sebastian Municipal Cemetery
Dear Mr.& Mrs Kicia,
Enclosed is City of Sebastian Certificate 2506 entitling you to full interment rights in Unit
4, Block 3, Lot 38, in the name of Richard A. and Judith A. Kicia
If you have any questions, please contact our office at 388-8209.
Sincerely,
Cathy T6stU3�
Records Clerk
Enclosure
rnv Cf
SE�sTt,
-:
HOME OF PELICAN ISLAND
Certificate No. 2506
CITY 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:
Richard A. and Judith A. Kicia
466 Autumn Terrace
Sebastian, FL 32958
In and for consideration of the sum of $1,000.00 is entitled to full interment
rights in the Sebastian Municipal Cemetery for the following lot:
Unit 4, Block 3, Lot 38
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 31St day of May, 2016.
CITY OF SEBASTIAN, FLORIDA
Joseph F: Griffin
City Manager
ATTEST:
anette William's; MMC_
City Clerk — -