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Home My WebLink About4-05-20Name Unit Lot Date of Mark -out 1 4^ ir2' r Date of Burial �2 si (b Time /O:o 135.1 7 E Name of Fune Authorized by anLr BAsT AN HOME OF PELICAN ISLAND 1225 Main Street Sebastian, FL 32958 (772) 589-5330 Phone (772) 589-5570 Fax October 10. 2016 George Gerhold 544 Concha Drive Sebastian, FL 32958 RE: Interment Rights to Unit 4, Block 5, Lot 20 Sebastian Municipal Cemetery Dear Mr. Gerhold, Enclosed is City of Sebastian Certificate 2520 entitling you to full interment rights in Unit 4, Block 5, Lot 20, in the name of George Gerhold. If you have any questions, please contact our office at 388-8209. Sincerely, Cathy Te to Records Clerk Enclosure My Of SEBASTIAN HOME OF PELICAN ISLAND Certificate No. 2520 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: George Gerhold 544 Concha Drive 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 5 Lot 20 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 22th day of September, 2016. CITY OF SEBASTIAN, FLORIDA Joseph F. Griffin City Manager ATTEST: anette WilliaA'is1C City Clerk Vero Beach Crematory, LLC 1830 Wilbur Avenue Vero Beach, Florida 32960 We hereby certify that these are the cremated human remains of.- Virginia f:Virginia R. Gerhold September 20, 2016 September, 26 2016 (Date of Death) (Date of Cremation) Strunk Funeral Home and Crematory Sebastian, Florida (Funeral Home in Charge) (City and State) 4734 By (Cremation ID Number) (Cr otorSignature) 09/22/2018 15:58 FUOERAL DIRECTOR'S REQUEST TO FOR BURIAL OPENING IN SEBASTIAN I FUNERAL HOME: ADDRESS: 1623 PHONE* 772-51 (Check One) xxxxx OPEN BURIAL ,OPEN CREMAI OPEN COLUMI BURIAL DATE AND FOR DECEASED: For information contac Kip Kelso .Cemetery Se: Sebastian Municipal Com (772) 589-2545 City Clerk's Office City Hall, 1225 Main Sh Sebastian, FL 32958 Office (772) 388.8215 or 38 Fax: (772) 589.5570 Funeral Home and Crematory - LOT XM NICHE ICE TIME:_ INIA R. GE Ri r #5894 P.001/001 Wednesday 9/28/2016 0:00 AM - GR��N1 SIDE COMMITTAL OLD NAME AND SIGNATURP OF LOT OWNER OR REPRESENTA" (Must provide proper do umentation of ownership) Name I certify that I have d fees have been paid NAME AND SIGNK Marshall Name Cemetery Sexton Ced I certify that I have ehe office and that all fees Signature lined the ownership of the above describtl site that all authorize opening of same. OF LICENSED FUNERAL DIRECTOR: Signature the ownership information by viewing owner's been paid: Cemetery sexton I 6 Date This form to be provided to Clerk's Office by Sexton for permanent jrcord upon S44 Ont,50.4A -bZ. FL 3;k9s,�? 9/22/2016 Date and administrative 9/2212016 Date confirming with Clerk's arc OF S HOME OF Pri.ICAN iSiAtM a52to 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. L�1�z�2E,F �-�tE2_trft3� Name(s) 544 0 o r e. vi -A I)2 i Je. Address Area Code &Phone Number �/ V 12Gtr11A C-2tfoc-b. Name & Residence Address of Intended OFFICE USE ONLY. Receipt is acknowledged in the sum of: Phan Purchaser 3;,1s? -A00%toa Dollars($ G000- 00 ) on this o e _day of rn LA t' , 20J -L- for the purchase of the following described Cemetery Lot(s) and/or Niche(s). Unit 4- , Block 5 , Lot(s) ola 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:\W W-DATA\Ms-Cemetery\RECEIPT.doc Interment w O H Circle One Disinterment TOTAL $ A voo • e City of The following documents were pro\ ded as Proof of Residency: CITY OF SEBASTIAN 10384 ADMINISTRATIVE SERVICES RECEIPT Name n� o j06Lb J Cash Date —`I 816 Vcheck# a`ZS ❑ 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 (001010 -343 900 l�o(�• oc cr y- ul-s- Ler av mo Total Pai /(KJO. 00 I lials Security Dep Held - Amount $ Check # White - Dept. of Origin • Yellow - Admin. Svcs. • Pink - Applicant CITY OF SEBASTIAN 10385 ADMINISTRATIVE SERVICES RECEIPT Name �' LUNK. I6E2i [) jCash Date 9 la 9 1(, Y-Qheck # '7!511 ❑ 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 noISb 1 3439os b�G ISb• °U 4rrBIk s 1prao t1'P Total Paid /�:65• 00 Ind Security Dep Held - Amount $ Check # White - Dept. of Origin • Yellow - Admin. Svcs. • Pink - Applicant