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HOME OF PELICAN ISLAND
Certificate No. 2625
GIT' ®F SEB STIR
Certificate of Interment Rights
IN ACCORDANCE with provisions of the Code of Ordinances of the City of
Sebastian, it is hereby certified that:
Andrea Mockridge
1100 Elm Street
Higginsville, MO 64037
In and for consideration of the sum of $1,000.00 is entitled to full interment
rights In the Sebastian Municipal Cemetery for the following lot:
Unit 4, Block 8, Lot 9B
of the Sebastian Municipal Cemetery,
as maintained on file in the records of the City Clerk
for use in accordance with the conditions, ordinances, resolutions, rules and
regulations prescribed therefore by the City of Sebastian.
CONVEYED THIS 8th day of April, 2019.
CITY OF SEBASTIAN, FLORIDA
ul E. Carlisl��
City Manager
ATTEST:
12n ette Williams, MN!C
City Clerk _ . _
an r
SEPTAN
HOME OF PELICAN ISLAND
1225 Main Street
Sebastian, FL 32958
(772)589-5330 Phone
April 10, 2019
Ms. Andrea Mockridge
1100 Elm Street
Higginsville, MO 64037
RE: Interment Rights to Unit 4, Block 8, Lot 9B, in the Sebastian Municipal Cemetery.
Dear Ms. Mockridge,
Enclosed is City of Sebastian Certificate 2625 entitling you to full interment rights in
Unit 4, Block 8, Lot 98 in the name of Andrea Mockridge.
If you have any questions, please contact our office at 388-8209.
Sincerely,
Cathy Te
Records Clerk
Enclosure
ma
SED"'!►N ass
Nam Or PELXAM ISLAND
City of Sebastian Municipal Cemetery Purchase Receipt
To enable the City of Sebastian to determine the correct rate, and in accordance with cemetery rate
regulations, proof of City residency of purchaser or person for whom lot is intended for interment must
be provided at time of purchase.
Andre& Mock'Ald 10
Name(s)�n I
ileo eLm �.)n�, HLa/'JSN
VA( , o Wo3-7.
Address
L( --c - A -aur
Area Code & Phone Number
,fLLtCL> /1.I tA-Lt'Yl E
Name & Residence Address of Intended Occupant if Other Than Purchaser
OFFICE USE ONLY
Receipt is acknowledged in the sum of
&Nr-- -t/ N-.SA'Ilb Dollars 1$ 1, On6 oe )
on this ?CJh day of APR 1 L- 20-11 for the purchase of the following described
Cemetery Lot(s) and/or Niche(s).
!!
Unit ` - , Block V , Lot(s) 9-• 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 & Closino "r'�C' d f w O H
Circle One
Vase and Ring for Niches (cost) Interment Disinterment
Temporary Marker Preparation & Installation
Sl�fre of Purchaser
TOTAL $� • ��
City of-S1-ebaj-In
The following documems were provided as Proof of
Residency:
I:1WW.DATA1Ms-CemeteMRECEIPT.doc I and
CITY OF SEBASTIAN 11676
ADMINISTRATIVE SERVICES RECEIPT
Name ,,///• O K2ttU9 ❑ Cash
Data 'C' 8 (i 1 f Check #'
❑ Credit
Amount Paid
001001 208001 Sales Tax
001001 220000 Security Deposit
001501 362100 Taxable Rent
001501 362150
Non -Taxable Rent
450010369900
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
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Initials
White - Dept. of Origin - Yellow -Admin. Svcs. - Pink -Applicant