The URL can be used to link to this page

Home My WebLink About4-08-09aName Unit Block C Lot ?-A I A4 Date of Mark-out- Date ark-out Date of Burial go�J, / % Time ' oO M r Name of Fune Authorized by Name Unit Block Lot 7 — D Date of Mark -out Date of Burial ?/A/ /l(-- Name of Funeral Home Authorized by Time Ga 74S� Certificate No. 2516 CITYCIFSEBASTIAN Certificate of Interment Rights IN ACCORDANCE with provisions of the Code of Ordinances of the City of Sebastian, it is hereby certified that: Karen Adams 9166 86th Street Vero Beach, FL 32967 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 8, Lot 9a 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 7th day of September, 2016. CITY OF SEBASTIAN, FLORIDA Joseph F. Griffin City Manager ATTEST: tewillisjtvnet Clerk = — • — - `'�' - 1 FUNERAL DIRECTOR'S REQUEST TO CITY OF SEBASTIAN FOR BURIAL OPENING IN SEBASTIAN MUNICIPAL CEMETERY SEBASTIgN NOME Oi PRION WND For information contact: Kip Kelso - Cemetery Sexton Sebastian Municipal Cemetery (772) 589-2545 City Clerk's Office City Hall, 1225 Main Street Sebastian, FL 32958 Office (772) 388-8215 or 388-8214 Fax: (772) 589-5570 FUNERAL HOME: ADDRESS: PHONE #: (Check One) OPEN BURIAL LOT Lot Block Unit -2—COPEN CREMAINS LOT LotBlock _Unit OPEN COLUMBARIUM NICHE Niche Block Unit W BURIAL DATE AND SERVICE TIME: 9.Z//jG /Q;oG/J, �cru9�DG� FOR DECEASED: etf/.�v g- �.sTeiZ rvame NAME AND SIGNATURE OF LOT OWNER OR REPRESENTATIVE: (Must provide proper documentation of ownership) Name Signature Dale I certify that I have determined the ownership of the above described Site that all site fees and administrative fees have been paid and authorize opening of same NAME AND SIGNATURE OF LICENSED FUNERAL DIRECTOR. '4 V,4 Name Signature Date --------------------------------------------------------------------- ------------- ------------ --------------------------- Cemetery Sexton Certification: I certify that I have checked the ownership information by viewing the owner's deed and confirming with Clerk's office Lind that all fees have been paid ^ 2/ Cemeye ry Skxton Date This form to be provided to Clerk's Office by Sexton for permanent record upon completion. We" 21 SEAWINDS CREMATORY Sebastian, Florida 735 Fleming Street - Sebastian, Florida 32958 www.seawindsffi.com (772) 589-1933 We hereby certify that these are the remains of HENRY GEORGE CUSTER �OS ! The remains were received SEAWINDS FUNERAL HOME & CREMATORY Cremation Permit No. 16-73377-5232 Issued at INDIAN RIVER COUNTY Date of Death MAY 18, 2016 Date of Cremation t;�011-14 By 0%/(D Cremator SEAWINDS CREMATORY Sebastian, Florida 735 Fleming Street • Sebastian, Florida 32958 www.seawindsfb.com (772) 589-1933 We hereby certify that these are the remains of DAVID PETER MCNAMARA !4 . The remains were received from COX—GIFFORD SEAWINDS FUNERAL HOME & CREMATORY Cremation Permit No. 14-73377-5516 Issued at INDIAN RIVER COUNTY Date of Death NOVEMBER 24, 20.1.4 Date of Cremation By Cremator CITY OF SEBASTIAN 10382 ADMINISTRATIVE SERVICES RECEIPT Name (� -j Cash �� Date `'�a 16 XCheck # 304 ❑ 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 I I.3�gas U 4 B 1 K g LUF A,4 Total Paid li if als Security Dep Held - Amount $ Check # White - Dept. of Origin • Yellow - Admin. Svcs. • Pink - Applicant 01Y OF SEOASTLA HOME OF PELICAN ISLAND 1225 Main Street Sebastian, FL 32958 (772)589-5330 Phone (772)589-5570 Fax September 19, 2016 Karen Adams 9166 86th Street Vero Beach, FL 32967 RE: Interment Rights to Unit 4, Block 8 Lot 9a Sebastian Municipal Cemetery Dear Ms. Adams Enclosed is City of Sebastian Certificate 2516 entitling you to full interment rights in Unit 4, Block 8, Lot 9a in the name of Karen Adams. If you have any questions, please contact our office at 388-8209. Sincerely, Cathy Tw Records Clerk Enclosure mr or SERASPAN A616 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 proyided at time of purchase. Code & 14"M 0 rA & Residence Address of Intended Occupant if Other Than Purchaser OFFICE USE ONLY Receipt is acknowledged in the sum of: 0vL- "bop Dollars ($ %(UO. 00) on this 7A day of &P-1-EmsI=mo 20 Ib for the purchase of the following described Cemetery Lot(s) and/or Niche(s). Unit , Block 8 , Lot(s) 9a- 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 It�Illl�ai `%I2 Interment /W O H Circle One Disinterment TOTAL $ 41aoe' • 00 City of Sebastian The following documents were provided as Proof of Residency: I:\W W-DATA\Ms-Cemetery\RECEIPT.doc and CITY OF SEBASTIAN 10376 ADMINISTRATIVE SERVICES RECEIPT Name ,/ `do -m -C O Cash Date 1 I b Xcheck# 30A U 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 (c,0/010 poo lbob.co Total Pai ��•� I itials Security Dep Held - Amount $ Check # White - Dept. of Origin • Yellow - Admin. Svcs. • Pink - Applicant