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HomeMy WebLinkAbout4-31-38e (,@/~. -===~-==----=C===C~=~~~=_-_'C=C.~.=C_=_C'C"-.=.-=_~_C'C_=C=_'_'_'CCC_-_=_--".C.-.-- U u __n ___ ___u___ nn_ __ ._u_+ ____u_n_ ___uuuu__un. _ _ non. _ _..............._._......_..._____ II II " " II II II II I: I il II II II II II ,I II II I II I I I I i I I I I I I I I I I i II I ! , i I I , I , j II I I' I [I I I I I I II I -~~~\ ~ __~==c-=.~c~:"~-=~~~=-. :__~-~--~- .~- i II II iI II II 'I .;~". ~~-c:-:~.~~,-:-,::~:c_=,~,~~:=_:=_~.__=~ ~ \ rc~f1r Certificate # 1875 HOME OF PELICAN ISLAND 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: Marilyn A. Antonellis (name) 1682 Laconia Street, Sebastian, Fl 32958 (address) (name) (address) (name) (address) in and for consideration of the sum of $900.00 , has purchased and is entitled to full interment rights in the Sebastian Municipal Cemetery for the following plot: Unit 4 , Block 31e , Lot(s) 38 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 ~ tday of February 2003 C~EBASTIAN,FLORIDA T~2~~ City Manager _. --/ /--==--=::~\ '~f II " " II il " II " II II Ii II II II II II II II !I II ._-----_._-~--_._-,~-~----- - - --------- ~-------- - --- ---------- .r Name .- / t./)..... /" /VI. ,/3</"l/ ,'~:.'.' " >. , " . " ::. j 'J' / Unit ""1/ Block /*,-1-1:----' J / &. J<. , Lot ,I:. Date of Mark-out / ,./ ) // ,/ I' ,,~-,., Time i . Date of Burial Name of Funeral Home ~.~ ~~;~:: /: / /'~ /? NO ~.f II f 1..,,, Authorized by / ..,,',/" .._..~1 a I 13/ J~ 1~ PLEASE PRINT ~~l1tSED LhD mil 5 ~e 1 IFIASn <MIOOUl ~~CUl Apr; \ <MONTHI 5' 1<155 DATE OF BIRm: lOAY) lY~ SIGNATURE: ~ ~ ~ PRINT '~ SIGNATURE:. . ' \Ljr\ ~~N~~O-~ ,~S' ~o 3 . ~hvi 1~1 ~ -b l1.e) lis ~ \iPBJ. LCu:.or\.lC~ $1 . SiJ0as+i(tJ\, FL. .:91'58 An~eJl;s (h) 52/1-5Sd-L1Y- ClJ-j ~34 - 13~d-. (C) 4-13-q/7~' DATE OF DEATH: DATE: ~\~ \63 FOR OFFICE USE OJ COLUMrnE~: ~ IEASTI NICH NlJl\tmER: 38 . 5 E. "(D )}\) So D f f i4 p-\ JGvc. TIF-l PA, ~ CITY OF SEBASTIAN CITY CLERK'S OFFICE RECEIPT 001001 208001 001501 322900 001501 341920 001501 341910 001501 362100 001501 362100 001501 362150 001501 343800 601010343800 001501 369400 001501 369400 680800 220681 680800 220682 680800 220683 Sales Tax Garage Sales Copies/Bid Specs. LOC/Code of Ordinances Community Center Rent Yacht Club Rent Non Taxable Rent o Cash ~. 1 51 6 Amount Paid Cemetery Lots Cemetery Lots .91J 0 "CJl1 LotINiche 3 B ,Block .3JE . Unit "l/f __ IntermentFee -- -uJ~ ,k~ /P6rOiJ Weekend Service Yacht Club Security Deposit Community Center Security Deposit fi:~~1 c&crj t: 130 ~ . Total Paid .t tJ8;? dd {},~ Initials White - Dept. 01 Origin. Yellow - Finance . Pink. Applicent o'ou It.:-5!OGU H .. UO 29"00 900,: or.: ~ J l .;' l......I "'\. ,_I ',.'