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Home My WebLink About4-31-44eName 1).4 ki/ /5 Unit Block Lot Authorized by E Date of Mark-out e■a"` Date of Burial Name of Funeral Home Time 54,44.3 /1 b 5 vtLW LA),(ZeL fri4 61 (penyi 5/ .d CITY OF HOME OF PELICAN ISLAND CITY S TI 0) Certificate No. 2164 Certificate of Interment Rights IN ACCORDANCE with provisions of the Code of Ordinances of the City of Sebastian, it is hereby certified that: Barbara Baute 821 Robin Lane /or Caroline White Sebastian, FL 32958 (name) (address) In and for consideration of the sum of $1,200.00 is entitled to full interment rights in the Sebastian Municipal Cemetery for the following niche: Unit 4 Block 31 Niche 44e 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 31 day of January, 2008. CITY FS ASTIAN, FLORIDA Ad Minner Manager ATTEST: i Sally Maio, MMC City Clerk Office Use Only Signature of Purchaser I: \W W- DATA \Ms Cemetery\RECEI PT.doc 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, residence of purchaser or person for whom lot is intended for interment must be provided at time of purchase /3Q -rba. ri 4 Caro (tsn Lijh {-c Name(s) j hr er 2,( leb b i n L-a Q S ebQ s t�f a n 3zq 5 Address 53-2 Area Code Phone N ber Dertn is Wh' fe, Residence Address o tended Occupant if er Than Purchaser Receipt is acknowledged in the sum of: .Q ,i 8 atL ytcut jiwievelatzt ct k ci %Dollars .O C) d on this 3) 5 r day of ,Tcivt IAOLir 20 0 8 for the purchase of the following described Cemetery Lot(s) and /or Niche(). Unit I' Block 3 Lot(s) Niche(s) 4 e, 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) 50 00 Interment Li 0,00 9-5,0 f\Al 0 H Disinterment Service fees are to be paid at time of need only Circle One TOTAL rat 5, 0 0 (Jt), y of Sebastian BARBARA A. BAUTE 01-04 821 ROBIN LANE SEBASTIAN, FL 32958 -4489 Pay .to the Order of BankofAmerica ACH R/T 0063100277 For (t 1j 63 E L' L tle :06 30000147I 0054969058 240 0 26 268 63 -4/630 fL 148E A+" CITY OF SEBASTIAN CITY CLERK'S OFFICE RECEIPT Name 1.3 lt.te, Cash Date 1 31— 0 `s illtheck# oc. Amount Paid No. 001001 208001 Sales Tax 001501 322900 Garage Sales 001501 341920 Copies/Bid Specs. 001501 341910 LDC/Code of Ordinances 001501 341930 Election Qualifying Fees 601010 343800 Cemetery Lots Lot/Niche 4 1 4 e✓ Block 31 Unit L t 001501 343805 Cemetery Fees Vase- r i n 0. vo o /c, 5,00 Li 00 N Total Paid I 1 5, 0 0 Initials White Dept. o rigin Yellow Finance Pink Applicant 3959 I (2.00 GUARDIAN® SAFETY BLUE WBL Obituaries 1 Death Notices 1 Newspaper Obituaries Online Obituaries 1 Newspaper Death Page 1 of 1 DENNIS E. WHITE Dennis E. White, 46, died Jan. 1, 2008, in Mexico. He was born in Everett, Mass., and lived in Sebastian for three years, coming from Sarasota and St. Petersburg. He served in the U.S. Army. He was a self employed computer consultant. Survivors include his wife of 14 years, Barbara Baute of Sebastian; daughters, Caroline Marie and Olivia Rose White, both of Sebastian; father, Frederick White of Port Charlotte; and brothers, Brian White and Charles White, both of Port Charlotte, Brendan White of Japan and Fred White of Massachusetts. SERVICES: A graveside service with inurnment will be at 11 a.m. Feb. 23 at Sebastian City Cemetery. Arrangements are by Seawinds Funeral Home and Crematory in Sebastian. A guest book may be signed at www.seawindsth.com /obit.php. Published in the TC Palm on 2/15/2008. Today's TC Palm obituaries and death notices Questions about obituaries and death notices or Guest Books? Contact Legacy.com Terms of use Powered by Lega y.com obituaries nationwide Back tit 1 4 L3 I Niche yge. http:// www .legacy.com/tcpalm/Obituaries. asp? Page LifeStoryPrint &PersonlD 103444516 2/15/2008 11. AUTHORIZED DISPOSITIONS)-CHECK 0 A. BURIAL OR (INCLUDES 0 B. CREMATION C. DISPOSITION OTHER THAN APPLICABLE ITEMS SCATTERING IN A CEMETERY D. SCIENTIFIC USE ENTOMBMENT) 0 E. TEMPORARY ENVAULTMENT F. DISINTERMENT OF CREMATED REMAINS I J G. SHIP IN TO CALIFORNIA FOR CORONER'S USE ONLY I. DISPOSITION PENDING LOCATION OF REMAINS- NAME AND ADDRESS IN A CEMETERY a H. TRANSIT OUTSIDE OF CAUFORNIA BURIAL OR SCATTERING IN A CEMETERY (INCLUDES ENTOMBMENT) 12A NAME AND ADDRESS OF CAUFORNIA CEMETERY 12B. DATE 12C. INTERMENT NUMBER- IFAPPUCABLE 120. SIGNATURE OF PERSON IN CHARGE OF BURIAL OR SCATTERING P. CREMATION 13A NAME AND ADDRESS OF CAUFORNIA CREMATORY SOUTHERN CALIFORNIA CREMATORY,601 D CRANE ST LAKE ELSINORE,CA,92530 13B. DATE EMATED !13C. CREMATION NUMBER- IF APPUCAB1E 7 FC OZ I O 767 13D. SIGNATURE OF PERSON IN CHARGE OF CREMATION SCIENTIFIC USE 14A. NAME AND ADDRESS OF CALIFORNIA FACILITY RECEIVING REMAINS 148. DATE RECEIVED 14C. SIGNATURE OF PERSON IN CHARGE OF FACIUTY TRANSIT 15A. NAME AND ADDRESS IN RECEIVING STATE OR COUNTRY WHERE REMAINS OR CREMATED REMAINS ARE TO BE SHIPPED BARBARA A.BAUTE,821 ROBIN LANE,SEBASTIAN, FLORIDA,32958 158. NAME AND ADDRESS OF PERSON IN CHARGE OF PLACING WITH THE CARRIER 15C. SIGNATURE OF PERSON IN CHARGE OF PLACING WITH THE CARRIER 150. DATE SHIPPED SCATTERING! BURIAL AT SEA OR DISPOSITION OTHER THAN IN A CEMETERY 16A. ADDRESS, NEAREST POINT ON SHOREUNE, OR OTHER DESCRIPTION SUFFICIENT TO IDENTIFY FINAL PLACE AND CAUFORNIA DISTRICT OF DISPOSITION: IF BURIAL AT SEA, ONLY ENTER LATITUDE AND LONGITUDE 16B_ DATE OF DISPOSITION `f g 16C. UCENSE NUMBER OF CREMATED REMAINS DISPOSER-4F APPLICABLE 16D. SIGNATURE OF PERSON IN CHARGE OF SCATTERI OR BURIAL 1A. NAME OF DECEDENT- -FIRST DENNIS 3. DATE OF BIRTH (MONTH, DAY, YEAR) 11/15/1961 4. DATE OF DEATH (MONTH, DAY, YEAR) 01/02/2008 2. SEX M 6A. CITY OF DEATH TIJUANA 7A. NAME OF INFORMANT BARBARA A.BAUTE 7C. INFORMANTS FULL MAIUNG ADDRESS STREET NUMBER AND NAME. CITY, STATE, ZIP CODE 821 ROBIN LANE,SEBASTIAN,FLORIDA,32958 ACKNOWLEDGEMENT OF APPLK ANTI hereby acknowledge as approve met 1 have the 9A. APPLICANT SIC�JATURE right to control disposition pursuant to Health Safety Code Section 7100, and that the disposition stated herein is one of the dispositions authorized by Hearth Safety Code Section 103055. PERMIT AND AUTHORIZATION OF LOCAL REGISTRAR CHANGE IN DISPOSITION REQUIRES A NEW P This pemdt is Issued in accordance with provisions of the Canaria Health and Safety Code and is the authonly for the disposition specified in this of California. 10A AMOUNT OF FEE PAID 11.00 10D. ADDRESS OF REGISTRAR OF DISTRICT OF DEATH -IF DEATH OCCURRED IN CAUFORNIA APPLICATION AND PERMIT FOR DISPOSITION OF HUMAN REMAINS USE BLACK INK ONLY MAKE NO ERASURES WHITEOUTS PHOTOCOPIES OR OTHER ALTERATIONS 108. DATE PERMIT ISSUED 18. MIDDLE EDWARD 76. RELATIONSHIP TO DECEDENT WIFE THE LOCAL REGISTRAR MAY DESTROY ANY ORIGINAL OR DUPLICATE PERMIT AFTER ONE YEAR FROM ISSUE DATE. STATE OF CALIFORNIA, DEPARTMENT OF PUBUC HEALTH, OFFICE OF VITAL RECORDS :10. LAST WHITE 5. (FETAL DEATH ONLY) DATE OF EVENT (MONTH, DAY, YEAR) 68. COUNTY OF DEATH-4F OUTSIDE OF CALIFORNIA, ENTER STATE MEXICO 8A TYPED NAME AND ADDRESS OF CALIFORNIA LICENSED FUNERAL DIRECTOR OR PERSON ACTING AS SUCH-STREET NUMBER AND NAME, CITY, STATE, ZIP CODE GUADALUPANA MORTUARY 2601 IMPERIAL AVENUE SAN DIEGO,CA,92102., JOSE M.CHAVEZ 10C. SIGNATURE OF LOCAL REGISTRAR ISSUING PERMIT 8B. CALIFORNIA UCENSE NUMBER- IFAPPUCABIE FD -1425 98. DATE SIGNED 02/05/2008 TO SHOW FINAL DISPOSITION NO1E: This pent gives no tight of disposal outside 1 VI TA AL L REC REGISTRAR S P B DISTRICT �SAN DIEGO 10D UPON AUTHORIZAT ON OF PERMIT, DISTRIBUTE COPIES AS FOLLOWS: L COPY 1- ACCOMPANIES REMAINS TO THE STATED PLACE OF DISPOSITION. PERSON IN CHARGE OF DISPOSITION IS RESPONSIBLE FOR COMPLETING AND FORWARDING THE PERMIT WITHIN 10 DAYS OF DISPOSITION TO THE REGISTRAR OF THE DISTRICT IN WHICH DISPOSITION OCCURRED OR THE DISTRICT NEAREST THE POINT WHERE THE CREMATED REMAINS WERE SCATTERED AT SEA' COPY 2 RETAINED BY PERSON IN CHARGE OF THE CEMETERY, CREMATORY, FACILITY FOR SCIENTIFIC USE. OR BY THE PERSON IN CHARGE OF DISPOSING OF THE CREMATED REMAINS. COPY 3 RETURN TO COUNTY OF DEATH WHEN THE REMAINS ARE DISPOSED OF IN ANOTHER DISTRICT. IF NOT APPLICABLE, COPY 3 MAY BE DISCARDED.' COPY 4- RETAINED BY REGISTRAR ISSUING THE PERMIT.* VS 9 Rev. 01/01/2008