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Home My WebLink About4-33-20J GY OF -SERAST N HOME OF PELICAN ISLAND COFDY Certificate No. 2012 Certificate of Interment Rights IN ACCORDANCE with provisions of the Code of Ordinances of the City of Sebastian, it is hereby certified that: John A Rich 462 Watercrest Street, Sebastian, FZ 32958 (name) (address) in and for consideration of the sum of $700.00 has purchased and is entitled to full interment rights in the Sebastian Municipal Cemetery for the following plot: Unit —4— Block 33 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 18th day of April, 2005. CITY OF SEBASTIAN, FLORIDA James A. Davis Interim City Manager ATTEST: Sally A. Maio, MMC City Clerk 0 0 Name Unit Block 33 - . Lot N f Date of Mark -out //C i Date of Burial �� / �'d Time /i • �� Name of Funeral Authorized by 5 ��d S / m i e_ O m • e f e a � d e a r2_ o ° ° ° ° °o cn u+ o ire c p � o 0 0 0 0 W W W N A A A r N O W Co (D c0 tD to O Oo W N O 0 C> CD O O O C n r n r^ O o d Q m Q O �m n cNi T O N N N N a [JTD. � O �.S.i c Q z I` t V El m w 3 0 c O M W_ n mm0 mom 340O I�4 T_ S Z! 2 m CO U Strunk Funeral Home & Crematory: Obituaries Strunk Funeral Home & Crematory MARIE NICOLET RICH (March 17, 1942 - February 28, 2010) MARIE NICOLET RICH Marie Nicolet Rich, 67, died February 28, 2010 at Sebastian River Medical Center, Sebastian, FL after a brief illness. She was born in Bridgeport, CT and lived in Sebastian for 25 years coming from Stratford, CT. She attended Saint Sebastian Catholic Church, Sebastian, FL. Survivors include her brother, John P. Rich of Sebastian, FL; sisters, Amelia A. Ruddock of Las Vegas, NV, Phyllis Sastram of Malabar, FL, 3 nephews, 1 great nephew and 1 great niece. Memorial contributions may be made to the Indian River County Fire Rescue, 4225 43rd Avenue, Vero Beach, FL 32967 in memory of Marie Rich for the dedication and service of Sebastian Fire Station 48, Barber Street, Sebastian, FL. SERVICES: A private Memorial Service will be held at a later date. Back Page 1 of 1 http: / /www.meaningfulfunerals. net /fhlprint.cfm? type = obituary &o_id = 549648 &fh_id =... 4/12/2010 Name unit Block Lot Date of Mark -out Date of Burial Name of Funeral Home Authorized by i ,011 O,7 SE w .ti HOME OF PELICAN ISLAND 1225 Main Street, Sebastian, Fl 32958 Telephone (772) 589 -5330 — Fax (772) 589 -5570 April 18, 2005 Mr. John P. Rich 462 Watercrest Street Sebastian, Fl 32958 Dear Mr. Rich: Enclosed is City of Sebastian Certificate 2012 for the purchase of Cemetery Lot 20, Block 33, Unit 4. Also enclosed is a copy of your receipt and the Rules and Regulations governing the Sebastian Municipal Cemetery. If you have any questions, please contact our office. Sincerely, Sally A. Maio, MMC City Clerk SAM:ar enclosure CITY OF SEBASTIAN CITY CLERK'S OFFICE 3346 RECED�T Name ❑ Cash - f ist C�aAn�.e. LJA, d8 D O� heck #�_ �,Q /�� id► t I J i 1C. 3 3, 7' 40 No. Amount Paid 001001208001 Sales Tax 001501322900 Garage Sales T - )04A A CLI-L ct~ "T� , 001501341920 Coplesm Specs. 001501341910 LDC1Code of Ordinances 001501341930 Election QuaBfykng Fees W 601010 343800 Cemetery Lob FL 329 s� LotlNK 1*42f - — Slock Unit 001501343805 Cemetery Fees �= i�.11t a,J v v A . SOD ®d� Total Paid , - �� Initial$ White - Dept. of Origin • Yellow - Finance • Pink - Appllcast art or SEBASTKN HOME OF PEUUIN 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, residence of purchaser or person for whom lot is intended for interment must be provided at time of purchase jXA Z44( Ngane(s) 1002�/ Address Area Code & Phone Number Residence Address of Intended Occupant if Other Than Purchaser Office Use Only is acknowledged in the sum of: owl Dollars ($ on this day of _, 20d--r' for the purchase of the following described Cemetery Lot(s) a d /or Niche(s). Unit _, Block f _, Lot(s) e16 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: Comer Markers (set of 4 - $20) Opening & ClosA/19 z3:I ea W O H Circle One Vase and Ring for Niches (cost) Interment Disinterment izz,TOT $ ,?' %S. d C) Signature of Purchaser tity of Sebastian Service fees are to be paid at time of need only I: \W W- DATA \Ms -Ce metery\RECEI PT -doo U 0131 .a 4 101 JUL 17 Pfd 3 55 qK/M CITY OF SEBASTIAN CHECK REQUEST Accounting Use Only . Input Date Document # Fiscal Period , Entered By Document Amount # of Lines Total HC Hash To Be Completed By Department Due Date Zz c2e U/ Single Check Y / N Vendor Number Document Organization Object Project IN TC Reference Code Code Code Amount A., Number of Lines 12 1 'f Js. Description • I MW _ ..W %AWAM�Aff iii :»nom %�A11`/1l1J , ADDRESS CITY / STATE /C D / ZIP CODE DRAW CHECK FRO APPROVED BY DATE BUDGET APPROVAL (5340Q6 AND 5450 ONLY) C� MAIL ATTACHED DOCUMENAnON (Except for remit slips, requesting department should attach a copy of documentation along with th e 'ginal) / OT�n INS — ACTIO}VS _ za;' � , , d / " "/ 7/ D. . 1 FLORIDA DEPARTMENT OF HEALT A. (TYPE) .Z0 v COP State of Florida, Department of Health, Vital Statistics APPLICATION FOR BURIAL - TRANSIT PERMIT 1. Name of First Middle Last Date Month Day Year Deceased of Rose Marie Rich Death April 13 2005 2. Place of Death City, Town or Location Name of (If neither, give street address) 1ndilan or River Sebastian Inst. Sebastian inst. River Medical Center 3. Name of Medical Address Phone Number Certifier David DePutron, D.O. 13836 U.S. #1 F—IMedical Examiner qPhysician Sebastian, FL 772- 589-6888 3. Name of Funeral Home /Di&pcl;-Biefleeell Address Fla. Lic. No. /Reg. No. Phone No. (Area Code) Establishment 1623 N. Central Ave. Strunk Funeral Home Sebastian, FL 1228 772- 589 -1000 i. Check a. U The medical certification has been completed and signed. A completed certificate of death accompanies this Appropriate application. Box b. Jane was contacted on 4/13/05 He /she verified that this death was from natural causes, that there was no accident nor other external cause of death, and that Dr. DePutron will complete and sign the medical certification of cause of death within 72 hours. C. 4Z 1 was contacted on He /she verified that Medical Examiner, will complete and sign the medics Icati use of death within 72 hours. i. Funeral Director/ n r F.E. No. /Reg. No. Date Signed ..gser 1862 4/13/05 3. BURIAL - TRANSIT PERMIT Permission is hereby granted to dispose of this body. Permit No1228-05 -0161 A five (5) day extension of time for filing the death certificate (exclusive of weekends) has been requested and granted since the physician has. been contacted by the funeral director and will not be able to complete the medical certification of cause -of -death section of the death certificate within 72 hours. []No extension of time for filing the death certificate has been requested. Regie48r -er Date Date Certificate Subregistrar Signature rps. issued: 4/13/05 Due: 4/18/05 AUTHORIZATION for CREMATION, DISSECTION, or BURIAL -AT -SEA Approval Number: Date Medical Examiner, , gave authorization by telephone to Funeral Director /Direct Disposer. Date The Medical Examiner's approval must be obtained before disposal by any of the above methods. A waiting period of 48 hours after death is required for all cremations. ). CEMETERY OR CREMATORY Method of Disposition: Place of Disposition Sebastian Cemetery BURIAL FISTORAGE Date of Disposition -Y`l8 CREMATION F10THER (Specify) Signature of Sexton 1 or Person -in- Charge J} 'his permit must be endorsed by the Sexton or person -in- charge (or by the Funeral Director /Direct Disposer when there is no Sexton) and returned 4thin 10 days to the local County Health Department in the county where disposition occurred. H 326, 8197 Obsoletes all Distribution: White: Cemetery or Crematory ( previous editions) Yellow: Funeral Director or Direct Disposer Rock Number: 57411000.0326 -2) Pink: Local Registrar ,-PW 0 PIP- City of Sebastian Sebastian Cemetery Ph. # 1(772) 589 - 2545 Fax # 1(772) Note : This is for informational purposes reguarding Monuments at Sebastian Cemetery . Note Please return to Dry Mix Sebastian ('emetery 1921 North Central Ave. Foundation poured Attention 32958 Cemetery by : quaiity aY1, date � Sexton stone installed by: quality vault Size 1 - 0 x 2 - 0 x 0 - 4 standard grey granite flat grass marker date : Names & Dates: His: Her Marie Rich D.O.B. D.O.B. 1942 D.O.D. D.O.D. 2010 Legal Description: Unit : 4 Blk.: 33 Lot : 20 Approved By: K . G . K . K G K. Checked By: . . Date Example By : quality vaults 4" 24" 12"