HomeMy WebLinkAbout4-08-03bcrrvoF
5 N
HOME OF PELICAN ISLAND
Certificate No. 2652
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:
Nord L. Johnson
2490 Cade Fernery Road
Seville, FL 32190
In and for consideration of the sum of $1000.00 is entitled to full interment
rights in the Sebastian Municipal Cemetery for the following lot:
Unit 4, Block 8, Lot 3B
of the Sebastian Municipal Cemetery,
as maintained on file in the records of the City Clerk
for use in accordance with the conditions, ordinances, resolutions, rules and
regulations prescribed therefore by the City of Sebastian.
CONVEYED THIS 13th day of September, 2019.
CITY OF SEBASTIAN, FLORIDA ATTEST:
Paul E. Carlisle
City Manager
WJE
Vanette Williams, MMC —
City Clerk
G IX
SEBASTIAN
HOME OF PELICAN ISLAND
1225 Main Sheet
Sebastian, FL 32958
(772)589-5330 Phone
(772)589-5570 Fax
September 16, 2019
Nord L. Johnson
2490 Cade Fernery Road
Seville, FL 32190
RE: Interment Rights to Unit 4, Block 8, Lot 3B in the Sebastian Municipal Cemetery.
Dear Mr. Johnson:
Enclosed is City of Sebastian Certificate 2652 entitling you to full interment rights in
Unit 4, Block 8, Lot 3B in the name Nord L. Johnson.
If you have any questions, please contact our office at 388-8209.
Sincerely,
Cathy Te to
Records Clerk
Enclosure
Wor Pr7.CAA Matra
City of Sebastian Municipal Cemetery Purchase Receipt
To enable the City of Sebastian to determine the correct rate, and in accordance with cemetery rate
regulations, proof of City residency of purchaser or person for whom lot is intended for interment must
be provided at time of purchase. • ''
9Vo�en L. �ld�.�s�>✓
Name(s) n
Address ,/
3g(,-` S-1 16,3-7
Area Code & Phone Number
Name & Residence Address of Intended Occupant if Other Than Purchaser
OFFICE USE ONLY
Receipt is `acknowledged in the sum of:
ONE 7/'le2lSFbJi1 Cam„d �loc Dollars($ Ij ccic. eE ,
on this 13'4k day of <�Epi �: z , 20)q for the purchase of the following described
Cemetery Lot(s) and/or Niche(s).
Unit 4 , Block 8 Lot(s) 3B 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 - $20) Opening & Closino
Vase and Ring for Niches (cost) Interment
Temporary Marker Preparation & Installation
Signature of Purchaser 0//
19W W-DATAWs-CemeterMECEIPT.doc
/W O H
Circle One
Disinterment
TOT _$ Ircoo. ov
City of Sebn
The following documents were provided as Proof of
Residency:
and
CITY OF SEBASTIAN 11883
ADMINISTRATIVE SERVICES RECEIPT
Name `i/c:f+n<SGnI DCash
Data 1A �ttheckN Mpg
❑ Credit
Amount Paid
001501 362150 Non -Taxable Rent
001001 220000 Security Deposit
001501 362100 Taxable Rent
001001208001 Sales Tax
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
001501220030 PD SHOP
001501 366602 PD SAFE
001501366603 PD COPE
(001 o 1 O X43 200 "-r boo.
L3iu A
Lo -r 113
-6;0 Total Pad /, C eo'
Initials
White - Dept. of Origin • Yellow -Admin. Svcs. • Pink - Applicant