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Home My WebLink AboutAlcove 1-COL-20DnYear of Birth: C' W tv.v�� +k,� y o-rc i-lmt -tv LIec•`�c IT- wait- ex'tm m �N W o aS cA aM 6. r V7 kAA%w . E - - - HOME OF PELICAN ISLAND SEBASTIAN MUNICIPAL CEMETERY Mailing Address: City of Sebastian 1225 Main Street Sebastian, FL 32958 (772) 589-2545 • Fax (772) 228-9927 DOUBLE PLAQUE FORM (PLEASE PRINT) Name of Deceased: First Middle Year of Birth: Year of Death: Name: 1(' /5A/=CG4 First j / / � B T Middle Year of Death: Signature: Print Name: �/w/�J '/Z Date: FOR OFFICE USE Unit Block Niche Vase & Ring (CIRCLE) YES NO Last Last Ling HOME OF PELICAN ISLAND Burial rights in the Sebastian Municipal Cemetery Name: David and Rebecca Thompson Address: 7218 Gallery Lane. Vero Beach, FL 32966 These following niches are intended for interment of the following individuals. Unit 3, Alcove 1-COL North-07Dn Intended for Keith Thompson and Carol Thompson Unit 3, Alcove 1-COL North-20Dn Intended for David Thompson and Rebecca Thompson Unit 3, Alcove 1-COL North-33Dn Intended for Scott Thompson and Michelle Thompson I hav a d der and the terms of this agreement. Dapson Date STATE OF FLORIDA COUNTY OF 0,;1-iu� The foregoing instrument was acknowledged before me by means of (4 physical presence or ( ) online notarization this Z6 4"' day of IM6 r64, zo2-5 , by David Thompson, who is personally known to me, or has produced FL Drive,-s L-�cz45c as identification. L�i- C,U� Q�Ic ewnq 6Ibtary Public, State of Florida,,, �1g1lE WIL(�, pSty PUS,:s r a S- oc Rebecca ThomdOn U Date MY COMMISSION v i EXPIRES 2-28-2027 STATE OF FLORIDA = Q COUNTY OF 1`-(6 ', du '� �� 1O. The foregoing instrument was acknowledged before me by means of ( ) physical presence or uuuu„x notarization this 7_( day of m4 rck, ZOZ 5 , by Rebecca Thompson, who is personally known to me,• 11E ....... IQ % or has produced FL Dr v t. '1 License- as identification. Po� .......... tary Public, State of Florida MY COMMISSION EXPIRES 2-28-2027 OF CITY OF SEELASTIN HOME OF PELICAN ISLAND Certificate No. 2973 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: David and Rebecca Thompson 7218 Gallery Lane Vero Beach, Florida 32966 In and for consideration of the sum of $14,400.00 is entitled to full interment rights in the Sebastian Municipal Cemetery for the following niches: Unit 3, Alcove 1, North COL, Niche 07113n Unit 3, Alcove 1, North COL, Niche 2013n Unit 3, Alcove 1, North COL, Niche 33113n 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 5th day of March, 2025. CITY OF SEBASTIAN, FLORIDA Brian Benton City Manager ATTEST: anette Williams, MMC City Clerk �ma HOME OF PELICAN ISLAND Burial rights in the Sebastian Municipal Cemetery Name: David and Rebecca Thompson Address: 7218 Gallery Lane, Vero Beach. FL 32966 These following niches are intended for interment of the following individuals. Unit 3, Alcove 1-COL North-07Dn Intended for Keith Thompson and Carol Thompson Unit 3, Alcove 1-COL North-20Dn Intended for David Thompson and Rebecca Thompson Unit 3, Alcove 1-COL North-33Dn Intended for Scott Thompson and Michelle Thompson I have read and understand the terms of this agreement. David Thompson Date STATE OF FLORIDA COUNTY OF The foregoing instrument was acknowledged before me by means of ( ) physical presence or ( ) online notarization this day of by David Thompson, who is personally known to me, or has produced as identification. Notary Public, State of Florida Rebecca Thompson Date STATE OF FLORIDA COUNTY OF The foregoing instrument was acknowledged before me by means of ( ) physical presence or ( ) online notarization this day of by Rebecca Thompson, who is personally known to me, or has produced as identification. Notary Public, State of Florida CITY OF SE�T�A1V HOME OF PELICAN ISLAND 1225 Main Street Sebastian, FL 32958 (772) 589-5330 Phone (772) 589-5570 Fax March 12, 2025 David and Rebecca Thompson 7218 Gallery Lane Vero Beach, Florida 32966 RE: Interment Rights in the Sebastian Municipal Cemetery Dear Mr. and Mrs. Thompson: Enclosed is the City of Sebastian Certificate 2973 entitling you to full interment rights in the Sebastian Municipal Cemetery for the following niches: Unit 3, Alcove 1, North COL, Niche 07Dn Unit 3, Alcove 1, North COL, Niche 20Dn Unit 3, Alcove 1, North COL, Niche 33Dn I have also enclosed a form designating your intentions for each of your niches. You can have this notarized and brought to City Hall to be kept with the Cemetery records, or you can come by when it is convenient and we will be glad to notarize it for you. I am also prepared to order your plaques after you decide on the wording you would like. The plaque company is able to put up to four words on the plaque without it being a special request. If you have any questions, feel free to give me a call at (772) 388-8216 Sincerely, Ann Thomas Administrative Assistant City Clerk's Office Enclosures GTY0F SEBASTIAN ram- 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 e- laced prior to any holiday but must be removed within ten days following the holiday. Ini' 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 Leisure Services Director, 1225 Main Street, Sebastian, Florida 32958. I al 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. Initia�� 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 $500.00 fine and/or not exceeding 90 days imprisonment, be denied the right to do further business in j W',�etery the city. ead and understand the contents on this form. Date -*/1-6i -I 3 crrY or HOME OF PELICAN ISLAND 1225 Main Street, Sebastian, FL 32958 772-388-8209 City of Sebastian Municipal Cemetery Purchase Order Dkv ( Nam-1 21 Address U i,x u i d 1 '12- 3 5 9- -1 -7 14 IZdge cca -1-1 2- 3 L(Z- vz -7-7 Area Code & Phone Number Name & Residence Address of Intended Occupant if Other Than Purchaser Receipt is acknowledged in the sum of: on this 541\day of NAGt,r 1 I_ Cemetery Lot(s) and/or Niche(s). Unit Block OFFICE USE ONLY Dollars ($ q, Q)� X3 , 20 D� for the purchase of the following described Lot(s) Niche(s) for use in accordance with the conditions, ordinances, resolutions, rules and regulations prescribed therefore by the City of Sebastian. A"vo I _COI_ _ 0 —1 Dn [-COL--w Dn Additional Fees paid at time of purchase: i —COL — 33 Dt'1 Opening & Closing fee for ceremony after hours or on holiday. $ Disinterment Fee $ TOTAL $ 14, W m . °" I�F ` Purchased City o" f Sebastian CITY OF SEBASTIAN 16298 FINANCE DEPARTMENT RECEIPT Name n I m Vu" ❑ Cash Date / �. kheck# 015 Ll Credit Amount Paid 001501 362150 Non -Taxable Rent 001001 220000 Security Deposit 001501 362100 Taxable Rent 001001 208001 Sales Tax 450010 369900 Airport Badge 450010 362521 AP Shade Hangar Rent 450001 208045 Airport Sales Tax 001501 347557 Community Center Revenue 001501 341920 General Fund Copies 001501 354100 Code Enforcement Fines 001001 220030 PD Shop with a Cop 001001220033 PD COPE 001001 220032 PD Cadets 010043 535270 PD Uniforms �Z 601010 343800 Cemetery L Sales 001501 343805 Cemetery Fees 480010 341920 Bldg Dept Copies Total Paid ) Ef 00 Initials White - Dept. of Origin - Yellow - Finance Dpt. - Pink - Applicant Dowi - bj i btlu+ �f vwyas A-e -�-ea CD A-1 .MVP (—C kEi711 T.�/o�Floif C-Pto L l-Co d -20Pn AEI tg ewI rn I.Z ' /=cc -,a -r- fO W/gre,�) l -C) L - 33 D n _ S C-C, r-r" cyoy> YIV- 7-27� rr— G-77