HomeMy WebLinkAboutAlcove 1-COL-059DscmoF
SEAT,
-INN
HOME OF PELICAN ISLAND
Certificate No. 2955
CITE QF'S BASTIAN
Certificate of Interment Rights
IN ACCORDANCE with provisions of the Code of Ordinances of the City of
Sebastian, it is hereby certified that:
Donald R. Wells
7536 Chasta Road
Micco, Florida 32976
In and for consideration of the sum of $4,800.00 is entitled to full
interment rights in the Sebastian Municipal Cemetery for the following niche:
Unit 3, Alcove 1, Niche 591)s
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 26th day of August, 2024.
CITY OF SEBASTIAN, FLORIDA
kriann tn
City Manager
ATTEST:
,' �E.&,uv �t W ,
Jonette Williams, MMC
City Clerk
CITY Of
5E RAN
HOME OF PELICAN ISLAND
1225 Main Street
Sebastian, FL 32958
(772) 589-5330 Phone
(772) 589-5570 Fax
August 29, 2024
Mr. Donald Wells
7536 Chasta Road
Micco, Florida 32976
RE: Interment Rights to Unit 3, Alcove 1, Niche 59Ds in the Sebastian Municipal
Cemetery.
Dear Mr. Wells,
Enclosed is City of Sebastian Certificate 2955 entitling you to full interment rights in
Unit 3, Alcove 1, Niche 59Ds in the name Donald Wells.
If you have any questions, please contact our office at 388-8209.
Sincerely,
I
Cathy Tes a
Records Specialist
Enclosure
CITY or
$E IAIV
HOME OF PELICAN ISLAND
1225 Main Street, Sebastian, FL 32958 772-388-8209
City of Sebastian Municipal Cemetery Purchase Order
Name(s)
Address
qp9 8d6
Area Code & Phone Number
M
Name & Residence Address of Intended Occupant if Other Than Purchaser
OFFICE USE ONLY
Receipt isacknowledgedin the sum of: �ur4�alti5,4rJQ �tre1 T C �.l.:r / Dollars($ `r
lgor�. oo)
on this 2L, day of A u iLS i
Cemetery Lot(s) and/or Niche(s).
Unit Block 4LeoVe I
20-R4, for the purchase of the following described
Lot(s) _ Niche(s) � ��S
for use in accordance with the conditions, ordinances, resolutions, rules and regulations prescribed
therefore by the City of Sebastian. n
Vk-Sc -1 K "rj C' �t (301. ".
Additional Fees paid at time of Durchase:
Opening & Closing fee for ceremony after hours or on holiday. $
Disinterment Fee $
TOTAL $ ` q 39 -
Signature of Purchaser
5�..
City of Sebastia
CITY OF SEBASTIAN 15767
ADMINISTRATIVE SERVICES RECEIPT
Name ❑ Cash
gab l,/ �poy�s
Date ay �CCheck #
❑ 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
001001 220033 PD COPE
001001 220032 PD Explorer
010043 535270 PD Uniforms Z/ goo601010 343800 Cemetery Lot Sales 7 0
.
001501 343805 Cemetery Fees �39_ C^
480010 341920 Bldg Dept Copies ,
Total aid 99
�v
Initials
White - Dept. of Origin • Yellow - Admin. Svcs. • Pink - Applicant
3Izel1214 67c
ML,
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:
Fl--� �-j NI e� m , i_,t.� L L S
First Middle Last
Year of Birth: /q L/6' /
Year of Death: 2-0 Z 7
Name:
D xi/t L D IAIE-LL 5
First Middle Last
Year of Birth: Q L4 a
Year of Death:
Signature: ! A,.z
Print Name: AONA 1,10 /Z /NCL-L S
Date: W-26—zC/
NICHE: 3
Unit
Vase & Ring (CIRCLE)
FOR OFFICE USE
f4i.cm�E I .QD.s
Block Niche
OYES NO