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Home My WebLink About4-22-20CITY OF SEBASTIAN 17061 FINANCE DEPARTMENT RECEIPT Name'-(��rv11 j ,(� 1�c- �_j Cash Date /Y y,T .J C*heck # a� O Credit o O_V�_OQ6 Amount Paid 001501 362156 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 601010 343800 Cemetery Lot Salesi� 001501 343805 Cemetery Fees 480010 341920 Bldg Dept Copies PD Shop with a Cop PD COPE PD Cadets PD SRT A17,I o. br • (iInitials White - Dept. of Origin - Yellow - Finance opt. • Pink - Applicant Name �o..ro� l� n,l. fti d V% Unit Block Lot Date of Mark -out -7, j—, Sr Date of Burial / —2_ L/ —2, Name of Furneral Home S �f ~ - Authorized by Funeral Director's Request to City of Sebastian for Burial Opening in Sebastian Municipal Cemetery Contact Information: City Clerk's Office Cathy Testa City Hall, 1225 Main Street Sebastian, FL 32958 Phone (772) 388-8209 ctestancitvofsebastian.orcr Funeral Home: Strunk Funeral Home & Crematory Address: 1623 N. Central Ave, Sebastian FL 32958 Phone:772-589-1000 (Check) F71 Open Burial Lot Open Cremains Lot Open Columbarium Niche Burial Date and Service Time: 7/24/2025 @12:OOPM Deceased Name: Barbara Ann Robinson Unit Block Lot Unit Block Lot Unit Block Niche Name and Signature of Lot Owner or Representative: (Must provide proper documentation of ownership) Print Name Signature Address Phone Number I certify that I have determined the ownershil administrative fees have been paid and autho Name and Signature of LicenseAF-ran Sandy Mastrando Print Name a/ Date of the above -described site that all site fees and 21-10opening of same. 1tor: 07/21 /2025 Date I certify that I have checked the ownership information by viewing the owner's deed and confirming with Clerk's Office and that all fees have been paid: Cemetery Certification: �r C mete Date This form is to be provided to Clerk's Office for permanent record upon completion. State of Florida, Department of Health, Bureau of Vital Statistics BURIAL TRANSIT PERMIT NWLJ'H DATE PRINTED: July 18, 2025 TRACKING NUMBER: 2025133089 1. DECEDENT INFORMATION Name of Deceased Date of Death BARBARA ANN ROBINSON July 16. 2025 Place of Death -County City, Town or Location Name of facility, or street address If not a facility BREVARD WEST MELBOURNE v.EST MELBOURNE He TH ww NEM IUTailoN CENTER Name and Address of Funeral Home/Direct Disposal Establishment Fla. Lic. No.1Reg. No. Phone Number STRUNK FUNERAL HOME. SEBASTIAN F041870 F041870 (772) 589-1000 1623 N CENTRAL AVE SEBASTIAN, FLORIDA, 3295B Funeral Director/Direct Disposer Fla. Lic. No./Reg. No. MARY A. KOPCHAK F486444 Medical Verification Statement Cara at the certifying physician's office, was contacted on 071IM025 by the funeral director listed above; he/she indicated that IDREES M KHAN, certifying physician, will complete and sign the medical certification of cause of death within 72 hours. 2. BURIAL - TRANSIT PERMIT The Florida Department of Health, Bureau of Vital Statistics hereby grants permission to dispose of this body in accordance with Chapter 382, Florida Statutes. Permit Number: 2025-Fe41870-5110 -- Date Issued: July 18. 2025 State Registrar 3. AUTHORIZATION for CREMATION, DISSECTION, BURIAL -AT -SEA, or HOSPITAL DISPOSITION Authorization given by Medical Examiner District Approval Number: 4. CEMETERY OR CREMATORY Place of Disposition: SEBASTIAN CEMETERY Method of Disposition: BURIAL Date of Disposition: EDRS maintains all statutorily required information regarding the death record and related burial transit permit, therefore, returning the permit to the county health department is no longer required. If the Place of Final Disposition wishes to retain the copy of the permit for their file they may do so. DH 326E. 10112 64V-1.011. Flanda Admirmvaeve Code i CITY OF SEBASTIAN HOME OF PELICAN ISLAND Certificate No. 2991 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: Jean Gloria Colberg 14755 891h Street Fellsmere, Florida 32948 In and for consideration of the sum of $2,400.00 is entitled to full interment rights in the Sebastian Municipal Cemetery for the following lot: Unit 4, Block 22, Lot 20 of the Sebastian Municipal Cemetery, as maintained on file in the records of the City Clerk for use in accordance with the conditions, ordinances, resolutions, rules and regulations prescribed therefore by the City of Sebastian. CONVEYED THIS 22"d day of July, 2025. CITY OF SEBASTIAN, FLORIDA Brian Benton City Manager ATTEST: nette Williams, MMC ity Clerk L 11 Y OI' SEBASTI�N HOME OF PELICAN ISLAND 1225 Main Street Sebastian, FL 32958 (772) 388-8216 beakins@cityofsebastian.org June 27, 2025 Ms. Jean Gloria Colberg 14755 89`s Street Fellsmere, FL 32948 RE: Interment Rights in the Sebastian Municipal Cemetery Dear Ms. Colberg, Enclosed is City of Sebastian Certificate 2986 entitling you to full interment rights in Unit 4, Block 22, Lot 20. I have also enclosed a copy of the Sebastian Municipal Cemetery Rules and Regulations Booklet. If you have any questions, please do not hesitate to contact me at (772) 388-8216. Sincerely, 4:/tJTiL� V Bridget Eakr s Executive Assistant Enclosures MYOF SEBAT;�w HOME OF PELICAN ISLAND -*�oQgOj 1225 Main Street, Sebastian, FL 32958 772-388-8209 City of Sebastian Municipal Cemetery Purchase Order 77elora yOAe Name(s) ` -Tpi5 I �h``Aree, -- Address Area Code & hone Number M Ann Name & Residence Address of Intended Occupant if Other Than Purchaser OFFICE USE ONLY Receipt is acknowledged in the sum of: -ix w -F-:XjYt- ttWn Or'OA Dollars ($,- ) on this day of 20_65 for the purchase of the following described Cemetery Lot(s) and/or Niche(s). J Unit 4 Block as Lot(s) ;�W 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 $ Vase and Ring for Niches (current market price) $ TOTAL $ � Rc'�O Signature of Purchaser -44 �-.6;14 City of Seba`9tian