HomeMy WebLinkAbout3-74-08arc OF
SEB�T�AN
HOME OF 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.
LArz.R YIn ;4-h
Name(s) '
/,A25-523ki) 37. i76z4-6A4e?z,� 3.7,
Address
-7a
& Residence Address of Intended Occupant if Other Than Purchaser
OFFICE USE ONLY
Receipt is acknowledged in the sum of:
—Two �+�A-a6 60Ito" — Dollars ($ 02, tW0- 00 )
on this S' day of U17- 20-9?.. for the purchase of the following described
Cemetery Lot(s) and/or N' he(s).
Unit s?, Block 74 , Lot(s) S 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
Sl atu of Purchaser
I:\W W-DATA\Ms-Cemetery\RECEIPT.doc
Interment
IW O H
Circle One
Disinterment
TOTAL $ o?Ud o . c o
City of Sebastian
The following documents were provided as Proof of
Residency:
and
My OF
SEBASTIAN
HOME OF PELICAN ISLAND
Certificate No. 2514
C,jT°Y 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:
Jerry & Laura Smith
1285583 rd Street
Fellsmere, FL 32948
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 lot:
Unit 3, Block 74, Lot 8
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 25th day of August, 2016.
CITY OF SEBASTIAN, FLORIDA
Joseph F.'Griffin
City Manager
ATTEST:
1,6anette Williams, MMC
City Clerk - -
arvo'
5E ASTIAN
HOME OF PELICAN ISLAND
1225 Main Street
Sebastian, FL 32958
(772) 589-5330 Phone
(772) 589-5570 Fax
August 31, 2016
Jerry & Laura Smith
12855 83rd Street
Fellsmere, FI 32948
RE: Interment Rights to Unit 3, Block 74 Lot 8 Sebastian Municipal Cemetery
Dear Mr. & Mrs. Smith
Enclosed is City of Sebastian Certificate 2514 entitling you to full interment rights in
Unit 3, Block 74, Lot 8 in the name of Jerry & Laura Smith.
If you have any questions, please contact our office at 388-8209.
Sincerely,
Cathy Test
Records Clerk
Enclosure
CITY OF SEBASTIAN 10117
ADMINISTRATIVE SERVICES RECEIPT
Name oc�j11 t w1 ❑ Cash
Date a,as'�% Check #5-4f
❑ Credit
Amount Paid
001001 208001 Sales Tax
001001 220000 SecurityDeposit
001501 362100 Taxable Rent
001501 362150 Non -Taxable Rent
450010 369900 AirportBadge
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 1�
0 c�^3��A'3 �I'r�i(XK7,Uo
Security Dep Held - Amount $ Check #
White - Dept. of Origin • Yellow - Admin. Svcs. • Pink - Applicant