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4-28-02
CROF S EBASTL HOME OF PELICAN ISLAND 1225 Main Street Sebastian, FL 32958 (772) 589-5330 Phone (772) 589-5570 Fax August 28, 2017 Mr. & Mrs. John Henry 680 Lake Drive Sebastian, FL 32958 RE: Interment Rights to Unit 4, Block 28, Lots 1&2, Sebastian Municipal Cemetery Dear Mr. Walters, Enclosed is City of Sebastian Certificate 2547 entitling you to full interment rights in Unit 4, Block 28, Lots 1 &2 in the name of John & Deborah Henry. If you have any questions, please contact our office at 388-8209. Sincerely, Cathy Te a Records Clerk Enclosure CITY L -f HOME OF PELICAN ISLAND Certificate No. 2547 Q V OF JS EBASUAN Certificate of Interment Rights IN ACCORDANCE with provisions of the Code of Ordinances of the City of Sebastian, it is hereby certified that: John & Deborah Henry 680 Lake Drive Sebastian, FL 32958 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 lots: Unit 4, Block 28, Lots 1 & 2 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 22nd day of August, 2017. CITY OF SEBASTIAN, FLORIDA Joseph F. Griffin City Manager ATTEST: anette Williaixrs,-MMC City Clerk - A4 • . t • .� Is 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. Name(s) 62o LcK2_ FL .3c2\9;S_W Address 77a 66T c 6 A Area Code & Phone Number Name & Residence Address of Intended Occupant if Other Than Purchaser OFFICE USE ONLY -Receipt is acknowledged in the sum of: `I w V 4-UA'-Y\.r �i, Dollars on this Nd day of u ST , 201_T_ for the purchase of the following described Cemetery Lot(s) and/or Niche(s). Unit 4- , Block A 9 , Lot(s) 14- A Niches) 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 ��, - . W Jill Interment /W O H Circle One Disinterment TOTAL City of Seb The following documents were provided as Proof of Residency: 1:1WW-DATAIMs-Cemetery\RECEIPT.doc I and CITY OF SEBASTIAN 10741 ADMINISTRATIVE SERVICES RECEIPT Name " & 0 Cash Date - I '% Check # 8 . 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 �G 161©-���iF- 2� L s to( c 0grr 14 61 t�4 ir Lars I t� L� Total Pod G�� Initials Security Dep Held - Amount $ Check # White - Dept. of Origin - Yellow - Admin. Svcs. - Pink - Applicant