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SE�TIAN
HOME OF PELICAN ISLAND
1225 Main Street, Sebastian, FL 32958 772-388-8209
City of Sebastian Municipal Cemetery Purchase Order
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Address ' �v2✓ -�iQ�•Cv
Area Code & Phone Number" Q
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Name & Residence Address of Intended Occupant if Other Than Purchaser
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Receipt is acknowledged in the sum of:
�a on this �j day of rl
Cemetery Lot(s) and/or Ni he(s).
Unit 3 Blocky
OFFICE USE ONLY
, 20 'L5 for the purchase of the following described
Lot(s) �0. 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 $
TOTAL $ Z,W) �u
Signature of P chaser ' iP�L� ity�of Sebastian
CITY OF
SEBASTIAN
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.
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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.
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.
ignat re Date
GrYOF
SEBASTL
HOME OF PELICAN ISLAND
1225 Main Street
Sebastian, FL 32958
(772) 589-5330 Phone
(772) 589-5570 Fax
April 4, 2025
Ms. Ashley Chelberg
155 Duval Street
Melbourne Beach. FL 32951
RE: Interment Rights in the Sebastian Municipal Cemetery
Dear Ms. Chelberg:
Enclosed is City of Sebastian Certificate 2976 entitling you to full interment rights in
Unit 3, Block 38, Lot 5a.
I have also enclosed a copy of the Sebastian Municipal Cemetery Rules and
Regulations Booklet.
If you have any questions, please contact the Clerk's Office at (772) 388-8216.
Sincerely,
KV1W*dVti1 "
Ann Thomas
Administrative Assistant
City Clerk's Office
Enclosures
CITY OF SEBASTIAN 16263
FINANCE DEPARTMENT (RECEEI1PT �/�
Name '�/( M r I ti7�a'���hy b e-(J
Date `Y1 20 2-�5- r3Check #
❑ 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 Cadets
010043 535270 PD Uniforms
601010 343800 Cemetery Lot Sales 1; e-o 5
001501 343805 Cemetery Fees Se✓W 506
480010 341920 Bldg Dept Copies
`� Total Paid � ODy
Initials
White - Dept. of Origin • Yellow - Finance Dpt. • Pink - Applicant