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HOME OF PELICAN ISLAND
Certificate No. 2715
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:
]ovana M.Pena
5 N Magnolia Street
Fellsmere, FL 32948
In and for consideration of the sum of $2,000.00 is entitled to full interment
rights in the Sebastian Municipal Cemetery for the following lot:
Unit 3, Block 17, Lot 7
of the Sebastian Municipal Cemetery,
as maintained on file in the records of the City Clerk
for use in accordance with the conditions, ordinances, resolutions, rules and
regulations prescribed therefore by the City of Sebastian.
CONVEYED THIS 21st day of September, 2020.
CITY OF SEBASTIAN, FLORIDA ATTEST:
J T �lWl r GLI cJ�ti.Qm a:
ifaul E. (tarlisle 4nette Williams, MMC
City Manager CAy Clerk
arva
SEBASTM
HOME OF PELICAN ISLAND
1225 Main Street
Sebastian, FL 32958
(772)589-5330 Phone
(772)589-5570 Fax
September 23, 2020
Ms. Jovana Pena
5 N. Magnolia Street
Fellsmere, FL 32948
RE. Interment Rights to Unit 3, Block 17, Lot 7 in the Sebastian Municipal Cemetery.
Dear Mr. Ramos:
Enclosed is City of Sebastian Certificate 2715 entitling you to full interment rights in
Unit 3, Block 17, Lot 7 in the name Jovana Pena.
If you have any questions, please contact our office at 388-8209.
R
sp-
Records Clerk
Enclosure
MI m
"OM OF PPiiCAM ISLAND
City of Sebastian Municipal Cemetery Purchase Receipt
To enable the City of Sebastian to determine the correct rate, and in accordance with cemetery rate
regulations, proof of City residency of purchaser and person for whom lot is intended for interment
must be provided at time of purchase. D
tl0 v' 1-n/a /'1. / eaA-
Names) ,N Mam G tJOL.ir4 S Feit5 M c72E F 3a 4�8
Address /r
Area Code & Phone Number
Name & Residence Address of Intended Occupant'rl Other Than Purchaser
OFFICE USE ONLY
Receipt is acknowledged in the sum of:
Dollars($aidm'ez) )
on this I s day of`SEP 1:5m b�2 , 20 a0 for the purchase of the following described
Cemetery Lot(s) and/or Niche(s).
Unit 3 , Block 17 , Lot(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:
Comer Markers (set of 4 - $20) Opening & Closina
Vase and Ring for Niches (cost) Interment
Temporary Marker Preparation & Installation
('k'ntF—� '/ i"u
Signature of Purchaser
IW O H
Circle One
Disinterment
TOTAL
City of Seba i
The following documents were provided as Proof of
Residency:
19WW-DATAVds-CCemetery%RECEIPT.dm
and
CITY OF SEBASTIAN 12682
ADMINISTRATIVE SERVICES RECEIPT
Name ��rt_�A-n/A f DNA Cash
Data `) j3,t /,�C�O ❑ Check #
❑ Credit
Amount Paid
001501 362150 Non -Taxable Rent
001001 220000 Security Deposit
001501 362100 Taxable Rent
001001208001 Sales Tax
450010 369900 Airport Badge
001001 218010 CobraServe
001501 354100 Code Enforcement Fines
001501347557 Community Center Revenue
001501341920 Copies
001501 351140 Parking Citation
001501 342100 Police Security Services
001501 220030 PD SHOP
001501 366602 PD SAFE
001501366603 P C PE
(�c�0 33 Cc��
ILK) e1 1—&T '7
e kip Total P i
Initials
While - Dept. of Origin • Yellow - Admin. Svcs. - Pink -Applicant