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SEBAS
HOME OF PELICAN ISLAND
Certificate No. 2529
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:
Mike & Deborah )ones
11105 Mulberry Street
Roseland, FL 32957
In and for consideration of the sum of $2,000.00 is entitled to full interment
rights in the Sebastian Municipal Cemetery for the following lot:
Unit 3, Block 74, Lot 7
of the Sebastian Municipal Cemetery,
as maintained on file in the records of the City Clerk
for use in accordance with the conditions, ordinances, resolutions, rules and
regulations prescribed therefore by the City of Sebastian.
CONVEYED THIS 17th day of March, 2017.
CITY OF SEBASTIAN, FLORIDA
Joseph F. Griffin
City Manager
ATTEST:
anette Williams, M:,ta--
City Clerk _
amcf
SE
HOME OF PELICAN ISLAND
1225 Main Street
Sebastian, FL 32958
(772) 589-5330 Phone
(772) 589-5570 Fax
March 23, 2017
Mike and Deborah Jones
11105 Mulberry Street
Roseland, FL 32957
RE: Interment Rights to Unit 3, Block 74, Lot 7, Sebastian Municipal Cemetery
Dear Mr. & Mrs. Jones,
Enclosed is City of Sebastian Certificate 2529 entitling you to full interment rights in
Unit 3 Block 74, Lot 7, in the name of Mike and Deborah Jones.
If you have any questions, please contact our office at 388-8209.
Sincerely,
I
Cathy T to
Records Clerk
Enclosure
Lara
SEIRA ST_ IAN
s�°1
HOME OF FEUCAN i5EAND
City of Sebastian Municipal Cemetery Purchase Receipt
To enable the City of Sebastian to determine the correct rate, and in accordance with cemetery rate
regulations, proof of City residency of purchaser or person for whom lot is intended for interment must
be provided at time of purchase.
KG +
Name(s) � ^
Address
Matt �n1C,rL�SS kms. �. tax„-1�v9
ame & Residence Address of Intended Occupant if Other Than Purchaser
Receipt is acknowledged in the sum of:
�1
OFFICE USE ONLY
Mm
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�57
S tura f c-.
Jars ($ :9CYD6- x' )
on this [� day of~-ftL(Zja)ex 20 I'7 for the purchase of the following described
Cemetery Lot(s) and/or Niche(s).
Unit _ , Block 94- , Lot(s) 'i 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
Signature of Purchaser
IAWW-DATAVds-Cem etery\RE CEIPT.doc
Interment
/W O H
Circle One
Disinterm
TOTAL $
City of Sebastia
The following documents were provided as Proof of
Residency:
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CITY OF SEBASTIAN 10423
ADMINISTRATIVE SERVICES RECEIPT
Name �Q`1ES _ ❑Cash
Date I I/ l 1 heck #(e�6
❑ 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
6- t o1 o 3432co L vr- *R000.00
Un{ rr 3' giK 7+ L &r '7
Total Paid
i ials
Security Dep Held - Amount $ Check #
White - Dept. of Origin • Yellow - Admin. Svcs. • Pink - Applicant
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FUNMAL HOMER df CREMATORY
916 17TH ST. • VERO BEACH, FLORIDA 32960
1623 N. CENTRAL AVE. • SEBASTIAN, FL 32958 V A 3
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