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Certificate No. 2639
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:
James A. Kemman
521 Biscayne Lane
Sebastian, FL 32958
In and for consideration of the sum of $4,000.00 is entitled to full interment
rights in the Sebastian Municipal Cemetery for the following lots:
Unit 3, Block 68, Lots 4,5,7,8
of the Sebastian Municipal Cemetery,
as maintained on file in the records of the City Clerk
for use in accordance with the conditions, ordinances, resolutions, rules and
regulations prescribed therefore by the City of Sebastian.
CONVEYED THIS 26th day of June, 2019.
CITY OF SEBASTIAN, FLORIDA ATTEST:
Pad E. Carlisle Jo nette Williams, MMC _
City Manager City Clerk = _ -
LM If
SESA§TuW
HOME OF PELICAN ISLAND
1225 Main Street
Sebastian, FL 32958
(772) 589-5330 Phone
(772)589-5570 Fax
June 28, 2019
Mr. James Kemman
521 Biscayne Lane
Sebastian, FL 32958
RE: Interment Rights to Unit 3, Block 68, Lots 4, 5, 7, 8 in the Sebastian Municipal
Cemetery.
Dear Mr. Kemman:
Enclosed is City of Sebastian Certificate 2639 entitling you to full interment rights in
Unit 3, Block 68 Lots 4,5,7,8 in the name James Kemman.
If you have any questions, please contact our office at 388-8209.
Sincerely,
Cathy Testa
Records Clerk
Enclosure
City of Sebastian Municipal Cemetery Purchase Receipt
To enable the City of Sebastian to determine the correct rate, and in accordance with cemetery rate
regulations, proof of City residency of purchaser or person for whom lot is intended for interment must
be provided at time of purchase.
Alam,,
►am K-.- iM,4TIJ
Name(s)
Address
dal �JtS�'�-`fn/E �A-rJE ai�A-5T1fEnl, �L 3�%�{
-7 7A • 5-24
Area Code & Phone Number
Name & Residence Address of Intended Occupant if Other Than Purchaser
OFFICE USE ONLY
Receipt is acknowledged in the sum of:
00
�cur�l-I�OI.ISR-rJQ /L+�► /jOe Dollars ($ •/%,bCo.on )
on this Z -4k\ day of N mn c 20 12 for the purchase of the following described
Cemetery Lot(s) and/or Niche(s).
Unit . Block 62 1 Lot(s) . T 2 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) Interment
Temporary Marker Preparation & Installation
Signature of Pdrehaser
I:\V V-DATA1Ms-CemeteryWECEIPT.doc
/W O H
Circle One
Disinterment
I TOTAL �. COC • ��'
City of Seba a
The following documents were provided as Proof of
�Residency:
M w'Q(S L.I to t -s-- and
CITY OF SEBASTIAN 11699
ADMINISTRATIVE SERVICES RECEIPT
Name l CM M
Date & 1. b' I Q
001001208001 Sales Tax
001001 220000 Security Deposit
001501 362100 Taxable Rent
001501 362150 Non -Taxable Rent
450010 369900 Airport Badge
001001218010 CobraServe
jy` Cash�y
Check #���
❑ Credit
Amount Paid
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
(001
329100
010
Zoning Fees
3�380o Lrsrs
CO oa
1)NILiK�bB LOT c}s,�,g�
� ` /- Total Paid" 4 coo' dd
-- Initials
White - Dept. of Origin • Yellow -Admin. Svcs. - Pink - Appllcanl