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Home My WebLink About4-40-10Unit Block Lot Date of Mark -out Date of Burial l "7 Time /� i o0 /r 5� 041 Name of Funeral Home 5 ' "i < PIA ' - Authorized by All' 14A Certificate No. 2413 Certificate of Interment Rights IN ACCORDANCE with provisions of the Code of Ordinances of the City of Sebastian, it is hereby certified that: Roger F. & Mary E. Hagle PO Box 1536 Bronson, FL 32621 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 40, Lot 10 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 2nd day of April, 2014. CITY OF SEBASTIAN, FLORIDA ATTEST: Joseph F. Griffin Sally A. Ka o, MMC Interim City Manager City Ciefk FUNERAL DIRECTOR'S REQUEST TO CITY OF SEBASTIAN FOR BURIAL OPENING IN SEBASTIAN MUNICIPAL CEMETERY For information contact: Kip Kelso Cemetery Sexton Sebastian Municipal Cemetery (772) 589 -2545 City Clerk's Office City Hall, 1225 Main Street Sebastian, FL 32958 Office (772) 388 -8295 or 388 -8294 Fax: (772) 589 -5570 FUNERAL HOME: Strunk Funeral Home and Crematory ADDRESS: 1623 North Central Avenue, Sebastian, Florida, 32958 PHONE* 772 -589 -1000 (Check One) X OPEN BURIAL LOT Lot 10_ _Block 40 Unit 40 Deed 2413 -OPEN CREMAINS LOT Lot Block Unit OPEN COLUMBARIUM NICHE Niche Block Unit N S E W BURIAL DATE AND SERVICE TIME: 10:00 a.m., Saturday, August 23, 2014 GRAVESIDE FOR DECEASED: Mary Elizabeth Hagle Name NAME AND SIGNATURE OF LOT OWNER OR REPRESENTATIVE: (Must provide proper documentation of ownership) Roger F. Hagle 2or F. Roakl 8/18/2014 Name Signature Date I certify that I have determined the ownership of the above described site that all site fees and administrative fees have been paid and authorize opening of same. NAME AND SIGNATURE OF LICENSED FUNERAL DIRECTOR: Marshall Voyles Name 9darshaf(Vo Signature 8/18/2014 Date Cemetery Sexton Certification: 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: j &_�4 a , kt,&a �� - - l / /,� /, Cemetery Sexto Date This form to be provided to Clerk's Pffice by Sexton for permanent record upon completion CITY OF SEBASTIAN CITY CLERK'S OFFICE 4909 RECEIPT Name e- ❑ Cash Date L_13 f Vheck# 1 7 0 8 '0 No. Amount Paid 001001 208001 Sales Tax 001501 322900 Garage Sales 001501 341920 Copies/Bid Specs. 001501341910 LDC /Code of Ordinances 001501341930 Election Qualifying Fees 601010 343800 Cemetery Lots Lot(Mche , Block , Unit 2-50,()o 001501 343805 Cemetery Fees & Total Paid 250, oc) initials White — Dept. of Origin • Yellow — Finance • Pink . Applicant 'Y4 w N mC 0 r 0 0 m 7 • m 1 T w n m • O V • w w a 0 W C�J1 rn o °o g o Co 0 0 0 0 0 o O C �w G O C O CD or m v @ w m m `� m w g'c CD CD T ? m O C n 7 w X � X` o r d �0 cI < ti cn ion I T � T_ S m Z m .`' 00 Ln -p- ajy of 41�r'q � I3 HOME OF PELICAN ISLAND 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. n Name(s) Address Area Code & Phone Number -7 7 2 - 115 -3 - 7„3 S Name & Residence Address of Intended Occupant if Other Than Purchaser jz4xt– OFFICE USE ONLY Receipt is acknowledged in the sum of: Dollars ($ 2ODD ° —° ) on this �31.v__ day of Z6L44= , 20_/_�_ for the purchase of the following described Cemetery Lot(s) and /or Niche(s). Unit _�, Block , 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.- Corner Markers (set of 4 - $20) Opening & Closing Vase and Ring for Niches (cost) Temporary Marker Preparation & Installatio Signature of urchaser I: \W W- DATA \Ms - Cemetery\RECEIPT.doc Interment /W O H Circle One Disinterment TOTAL $ C)000 City of Seba Ian The following documents were provided as Proof of Residency: /� and 275 Kusilek Street River Falls, Wl 54022 March 8, 2011 Jeanette Williams Deputy City Clerk City ofSebastian c/o Sebastian City Hall 1225 Main Street Sebastian, H 32958 Dear Ms. Williams: We, the heirs of Elizabeth Ferguson, wish to sell Sebastian municipal cemetery Lot 10 back to your city. Please see the enclosed copy of the certified deed. Our mother's cmcnmuoo have been placed oo top nf our father's casket io Lot 9' We both live in Wisconsin and have uo need for Lot 10. Please make the check payable to Onnolee E Hill and mail it to the above address. We will then send you the original deed. Sincerely yours, ' Onno|eeEHill /u/«/�m� IAp OF Y , 9,q 5 S CITY OF SEBASTIAN CHECK REQUEST Accounting Use Only Input Date Fiscal Period Document # Entered By Document Amount # of Lines Total HC Hash Due Date To Be Completed By Department 3/18/2011 Single Check Y / N Vendor Number LN TC Reference Organization Code Object Code Project Code Amount 601011 534959 $190.00 Description Number of Lines Amount $190.00 The Lee Sisters wish to sell back one of their parent's cemetery lots. The parents paid $200.00 a piece for each lot. Refund will be $200 minus admin fee of (request attached) ISSUE CHECK TO NAME Onnolee F. Hill ADDRESS 275 Kusilek Street CITY River Falls STATE WI ZIP CODE 54022 DRAW CHECK FROM SEE BELOW , APPROVED BY AL DATE 3/11/2011 BUDGET APP 0 GI(7 MAIL ATTACHED DOCUMENATION (Except for remit slips, requesting department should attach a copy of documentation along with the original) OTHER INSTRUCTIONS Please give copy of check to Clerk's office sF SEBASTIAN -'7 MAIN _,TROT 63 -643 r.��.r:F��,30 077266 670 77266 A'NEgA1 .ACCOUNT HOME OP 1�:LATqrj { I Nnr�F_ -,NECK D'ATF �r (-,'HECK AMOUNT t 38 03/18/201 $190. * * * * * ** *190 DOLLARS AND NO CENTS lee F . H11 IFNOT PAID WITHIN 90 DAYS Kusilek Street J1001D "4 r Falls WI 54022 TWO SIGNATURES REQUIRED 11'07726611' 1:06?0064 3 24 20000 2 7 3L629611' 77266 IjY OF SEBASTIAN [ARI SE3ASTIAN, FL 32958 - - - - - -- — - -- - - - - - -- INVOICE DATE Y INVOICE NUMSER Y INVOICE DESCRIPTION Y NET INVOICE AMOUNT 03 /11 /11IRefund ILee Sisters selling back 385 Onnolee F. Hill 031811 190.00 190.00 PO NO. 077266 VOUCHER 82061 77266 q _//U- (0 Lo 9, 10 ®/ 2/19 91 ,.k 40 Paid-by CEMETERY Receipt No... ,6 61, ... , , , , ,Dated .......... f .................. Blu NO. 1. nn 4 List Price $ .... .............. Maximum No. Burial Spaces .................. Net Paid $ .. 0 0 :. 0 . Monument permitted .......... 4 1315 Elizabeth Ferguson Leo Ferguson interred 2/18/91�Lot 242 Del Monte Rd. ( Data a ve this ne for City Record only) 32958 Sebastian, Fl. (lifli of OthaSttatt (� y� v S t t A x`315 it ut r 1 ID je jP b NO. THIS INDENTURE MADE Md, ....19tI1........... day of ..... Fe-bruary .......................... A. between the City of Sebastian, a municipal corporation existing under the laws of the State of Florida, as Grantor and Elizabeth Ferguson 242 Del Monte Rd.• ............................. ............................... .......................... ..................Sebas,tian,.. Florida ..$29 5.$................. ............................... of the County of ....Indian Riyer „ .... au�l State of .......Florida AS Grantee, WITNESSETHr That the Grantor for and in consideration of the sum of $ ..4.0..0....0..0 ..... , , , , , , , to it in hand paid, the receipt whereof is herewith ac- knowledged, does by this instrument grant, bargain, sell, release, convey and confirm unto the Grantee , . , , , , , , , heirs, legal representatives and assigns the following property situated in Sebastian, Indian River County, Florida, to wit: All of Lot(s) 9 1 , Block, .. 49, . , , UNIT , 4, cemeter , of Sebastian municipal p y as per Plat Number 1 thereof recorded in Plat Book 2, at page 6S of the public records in the office of the Clerk of the Circuit Court of St. Ludo County of Florida; said land now lying and being in Indian River County, Florida To Have and to Hold the same forever; provided that said property shall be used solely and exclusively for the interment of the human dead and shall be used, kept and maintained at all times in accordance with the rules and regulations, ordinances and resolutions of the City of Sebastian, Florida, hereto- fore, now and hereafter adopted or provided for tfp government and operation of said cemetery. The conditions, restrictions and requirements contained In this instrument shall be covenants running with the land. In the event of the failure of the owner of any property situated within said cemetery to ob- serve and comply with such rules, regulations, resolutions and ordinances and the conditions of the dead of conveyance thereof then the title of such owner in and to said property shall terminate and the same shall revert to the City of Sebastian, Florida. IN WITNESS WHEREOF, The said party of the first part has caused this instrument to be executed in its name and on its behalf by its Mayor and attested by its City Clerk and its corporate goal to be hereto affixed, the day and year first above written. Attests ....... ., City Clerk eq, Sealed and Delivered Presence ofs C.. . TE OF FLORIDA INTY OR TM TAX RTUVIP CITY OF SEBASTIAN, FLORIDA By..................... M r (0tg oSeal) Vero Beach Crematory, LLC 1830 Wilbur Avenue Vero Beach, Florida 32960 We hereby certify that these are the cremated human remains of: Mary Elizabeth Hagle August 15, 2014 (Date of Death) Strunk Funeral Home and Crematory (Funeral Home in Charge) 3724 (Cremation ID Number) August 19, 2014 (Date of Cremation) Sebastian, Florida (City and state) By. / (Cremator Signoture)