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Home My WebLink About3-59-07Name A a y --, ip, 6, O pe, < a Unit Block Lot 7 Date of Mark -out ,,- 2—! - 2— 5 i Date of Burial Name of Furneral Home Authorized by ��SF/ Funeral Director's Request to City of Sebastian for Burial Opening in Sebastian Municipal Cemetery Contact Information: City Clerk's Office Cathy Testa City Hall, 1225 Main Street Sebastian, FL 32958 Phone (772) 388-8209 ctesta(a,,citvofsebastian.orR Funeral Home: Strunk Funeral Home Address:1623 N. Central Ave, Sebastian, Florida 32958 Phone:772-589-1000 (Check) FTOpen Burial Lot Unit3 Block59 Lot? Open Cremains Lot Unit Block Lot Open Columbarium Niche Unit Block Niche Burial Date and Service Time: 6/30 11:00AM Deceased Name: Karen M. Conover Name and Signature of Lot Owner or Representative: (Must provide proper documentation of ownership) Print Name Signature Date Address Phone Number I certify that I have determined the ownership of the above -described site that all site fees and administrative fees have been paid and authorized opening of same. Name and Signature of License irector: Sandy Mastrando � / 06/25/2025 Print Name Si ure Date I certify that I have checked the ownership information by viewing the owner's deed and confirming with Clerk's Office and that all fees have been paid: Cemetery Certification: 96metery,/ V ___6—z,�=�a_ S�_ Date This form is to be provided to Clerk's Office for permanent record upon completion. Funeral Director's Request to City of Sebastian for Burial Opening in Sebastian Municipal Cemetery Contact Information: City Clerk's Office Cathy Testa City Hall, 1225 Main Street Sebastian, FL 32958 Phone (772) 388-8209 etestai7a.citvofsebastian.ore Funeral Home: Strunk Funeral Home Address:1623 N. Central Ave, Sebastian, Florida 32958 Phone:772-589-1000 (Check) _Open Burial Lot Unit3 Block59 Lot? _E-1 Open Cremains Lot Unit Block Lot F_ Open Columbarium Niche Unit Block Niche Burial Date and Service Time: 6/30 11:00AM Deceased Name: Karen M. Conover Name and Signature of Lot Owner or Representative: (Must provide proper documentation of ownership) Print Name Signature Date Address Phone Number I certify that I have determined the ownership of the above -described site that all site fees and administrative fees have been paid and authorized opening of same. Name and Signature of License irector: Sandy Mastrando C� ® / 06/25/2025 Print Name Si a Date 1 certify that I have chec$ed the ownership information by viewing the owner's deed and confirming with Clerk's Office and that all fees have been paid: Cemetery Certification: Cemetery Date 4 This form is to be provided to Clerk's Office for permanent record upon completion. State of Florida, Department of Health, Bureau of Vital Statistics BURIAL TRANSIT PERMIT NE�TM DATE PRINTED: June 25, 2025 TRACKING NUMBER: 2025116924 1. DECEDENT INFORMATION Name of Deceased Date of Death KAREN M CONOVER June 23, 2025 Place of Death - County City, Town or Location Name of facility, or street address if not a facility INDIAN RIVER SEBASTIAN 29 TREASURE CIRCLE Name and Address of Funeral Home/Direct Disposal Establishment Fla. Lic. NoJReg. No. Phone Number STRUNK FUNERAL HOME- SEBASTIAN F041870 F041870 (772) 589-1000 1623 N CENTRAL AVE SEBASTIAN, FLORIDA, 32958 Funeral Director/Direct Disposer Fla. Lic. No.lReg. No. MARY A. KOPCHAK F486444 Medical Verification Statement Staff at the certifying physician's office, was contacted on 06/23/2025 by the funeral director listed above; he/she indicated that MICHAEL ANTHONY VENAZIO, certifying physician, will complete and sign the medical certification of cause of death within 72 hours. 9 BURIAL - TRANSIT PERMIT The Florida Department of Health, Bureau of Vital Statistics hereby grants permission to dispose of this body in accordance with Chapter 382, Florida Statutes. Permit Number: 2025-F()4187June -5096 �— Date Issued: June 23. 2025 State Registrar 3. AUTHORIZATION for CREMATION, DISSECTION, BURIAL -AT -SEA, or HOSPITAL DISPOSITION Authorization given by Medical Examiner District Approval Number: 4. CEMETERY OR CREMATORY Place of Disposition: SEBASTIAN CEMETERY Method of Disposition: BURIAL Date of Disposition: EDRS maintains all statutorily required information regarding the death record and related burial transit permit, therefore, returning the permit to the county health department is no longer required. If the Place of Final Disposition wishes to retain the copy of the permit for their file they may do so. DH 326E, 10112 64V-1.011, Florida Administrative Code CITY OF SEBASTIAN HOME OF PELICAN ISLAND Certificate No. 2988 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: William Conover 29 Treasure Circle Sebastian, Florida 32958 In and for consideration of the sum of $5,700.00 is entitled to full interment rights in the Sebastian Municipal Cemetery for the following lot: Unit 3, Block 59, Lots 7 & 8 of the Sebastian Municipal Cemetery, as maintained on file in the records of the City Clerk for use in accordance with the conditions, ordinances, resolutions, rules and regulations prescribed therefore by the City of Sebastian. CONVEYED THIS 27", day of June, 2025. CITY OF SEBASTIAN, FLORIDA I 5 Brian Benton City Manager ATTEST: J6nette Williams, MMC City Clerk CITY OF SE$ASTIN QNW HOME OF PEUCAN ISLAND 1225 Main Street Sebastian, FL 32958 (772) 388-8216 beakins@cityofsebastian.org June 27, 2025 Mr. William Conover 29 Treasure Circle Sebastian, FL 32958 RE: Interment Rights in the Sebastian Municipal Cemetery Dear Mr. Conover, Enclosed is City of Sebastian Certificate 2986 entitling you to full interment rights in Unit 3, Block 59, Lots 7 & 8. I have also enclosed a copy of the Sebastian Municipal Cemetery Rules and Regulations Booklet. If you have any questions, please do not hesitate to contact me at (772) 388-8216. Sincerely, Bridget Eakins Executive Assistant Enclosures CTIYOF S B �TIAN HOME OF PELICAN ISLAND Sebastian Municipal Cemetery Artificial and fresh flower, blankets. No more than two bouquets of artificial or fresh flowers will be allowed at any gravesite. Artificial flower arrangements will be permitted to remain until they become faded or unsightly. Fresh flowers will remain until unsightly. No glass or ceramic flower containers or ornaments shall be allowed, however, a plastic flower container no more than six inched deep, six inches wide and 24 inches long may remain in place unless broken or in decrepit condition. No wires shall be allowed to hold flower arrangements permanently in place at the interment site. Blankets are allowed to be placed prior to any holiday but must be removed within ten days following the holiday. Initial Sod placement. Sod will be placed after the ground has settled following the burial to ensure a level surface and proper establishment of the grass. This process helps maintain the overall appearance and integrity of the cemetery grounds. Initial Permanent Markers. All markers shall be installed within 120 days after burial. Where this regulation renders a hardship or presents any special problems, such as an estate not settled, special consideration will be given. Request for special consideration should be make in writing to the Sebastian Parks and Recreation Director, 1225 Main Street, Sebastian, Florida 32958. Initial Unlawful Conduct. Our Ordinance states that it shall be unlawful for any person to possess or consume any type of alcoholic beverage within the cemetery grounds. Initial Violations of article; penalties. A violation of any of the rules and regulations contained in this article shall be considered a violation of the ordinances of the city, and any person adjudicated in violation of such rules and regulations shall, in addition to any penalty imposed by court not exceeding $500.00 fine and/or not exceeding 90 days imprisonment, be denied the right to do further business in the cemetery of the city. Initial I acknowledge that I have read and understand the contents on this form. Signature Date �n 5 O AN HOME OF PELICAN ISLAND 1225 Main Street, Sebastian, FL 32958 772-388-8209 City of Sebastian Municipal Cemetery Purchase Order Name(s) �/ /') � al r-r) h A CPC Address ---,� Area Code & Phone Number _ 77� -3 R Fk— �/ 7 Name &Residence Address of Intended Occupant if Other Than Purchaser A r, }- a n lr OFFICE USE ONLY Receipt is acknowledged in the sum of: Ue 1�ou5and,SeJen ku„o(red �a �� Dollars($5 7vC�,°" ) on this Z q+k day of _Tzcvi �c_ Cemetery Lot(s) and/or Niche(s). Unit 3 Block 5-9 , 20 z5 for the purchase of the following described Lot(s) 7 -4" S 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: Opening & Closing fee for ceremony after hours or on holiday. $ Disinterment Fee $ Vase and Ring for Niches (current market price) $ TOTAL Signature of Purchaser City of Sebastian