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4-18-37a
Name /e,, I� A e ib 4J e,14:s J X• Y , .2 4�4 5 . Unit Block Lot .1 Z Date of Mark -out pp / Date of Burial 11118116. Time /� ®b I4 •! / Q12 �1 Y1► f/> Name of Funeral Home Authorized by GTY OF SEBASTLAN HOME Of PELICAN ISLAND 1225 Main Street Sebastian, FL 32958 (772) 589-5330 Phone (772) 589-5570 Fax September 20, 2016 Richard Waugh 558 Breakwater Terrace Sebastian, FL 32958 RE: Interment Rights to Unit 4,Blk 18,Lot 37a Sebastian Municipal Cemetery Dear Mr. Waugh, Enclosed is City of Sebastian Certificate 2519 entitling you to full interment rights in Unit 4,BIk 18,Lot 37a in the name of Richard Waugh. If you have any questions, please contact our office at 388-8209. Records Clerk Enclosure S� cn) L-+ SE HOME OF PELICAN ISLAND Certificate No. 2519 Certificate of Interment Rights IN ACCORDANCE with provisions of the Code of Ordinances of the City of Sebastian, it is hereby certified that: Richard Waugh 558 Breakwater Terrace Sebastian, FL 32958 In and for consideration of the sum of $500.00 is entitled to full interment rights in the Sebastian Municipal Cemetery for the following lot: Unit 4, Blk 18, Lot 37a of the Sebastian Municipal Cemetery, as maintained on file in the records of the City Clerk for use in accordance with the conditions, ordinances, resolutions, rules and regulations prescribed therefore by the City of Sebastian. CONVEYED THIS 16th day of September, 2016. CITY OF SEBASTIAN, FLORIDA Joseph F. Griffin City Manager ATTEST: anette Williams, MWiC City Clerk - _ -'� .;:.Ri=,mom,-,.�•?� • 1 • � i City of Sebastian Municipal Cemetery Purchase Receipt To enable the City of Sebastian to determine the correct rate, and in accordance with cemetery rate regulations, proof of City residency of purchaser or person for whom lot is intended for interment must be provided at time of purchase. Names) *----- Address !;O -S- 772- eee y Area Code & Phone Number /C^I C,N�r�� %J-);= LLs Name & Residence Address of Intended Occupant if Other Than Purchaser OFFICE USE ONLY Receipt is acknowledged in the sum of: Dollars ($ Soo ©� } on this 0 c day of 1(1'::::1, 20 At�, for the purchase of the following described Cemetery Lot(s) and/or Niche(s). Unit L- , Block 12 , Lot(s) 3-711' 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 Sig ature of Purchaser Interment /W O H Circle One Disinterment TAL $ �t-;�o. 00 ebastian The following documents were provided as Proof of Residency: 1:1WW-DATAIMs-Cemetery\RECEIPT.doc I and CITY OF SEBASTIAN 10381 ADMINISTRATIVE SERVICES RECEIPT Name ❑ Cash Date Check # 36 1 0 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 621-)/016 343 goo moo, ae 1314 11 Lal- 37A Total Pa Rz 6 oo tiaisSecurity DepZ�d - Amount $ Check # White - Dept. of Origin - Yellow - Admin. Svcs. - Pink - Applicant