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HomeMy WebLinkAbout4-31-53eCITY OF SEBASTIAN 10441 ADMINISTRATIVE SERVICES RECEIPT Name �FL6UU V Cash Date 5 -9-AQV7 YCheck#lo, ❑ Credit Amount Paid 001001 208001 Sales Tax 001001 220000 Security Deposit 001501 362100 Taxable Rent 001501 362150 Non -Taxable Rent 450010 369900 Airport Badge 001001218010 CobraServe 001501 354100 Code Enforcement Fines 001501 347557 Community Center Revenue 001501341920 Copies 001501 351140 Parking Citation 001501 342100 Police Security Services 001501 329200 Site Plan Review 001501 329300 Subdivision/Plat Review 001501 329100 Zoning Fees ©0' 501 :34-3126a L&O/tsE g0.0a �g Total Pal !� �� I"Is Security Dep Held - Amount $ Check # White - Dept. of Origin • Yellow - Admin. Svcs. • Pink - Applicant Name Unit Block Lot u:. J 401 Date of Mark -out Date of Burial 3�/tg �� � Time Name of Fune Authorized by IT Name x"iJ�4'e! -G_OE�t/Iii� H1�5 Unit Block Date of Mark -out Date of Burial / � / � � Time � • �� Name of Funeral Home Authorized by MI MINV RMlu IRY Sebastian, Florida 735 Fleming Street • Sebastian, Florida 32958 www.seawindsfli.com (772) 589-1933 We hereby certify that these are the remains of # 7:QAo MAR,Jb1RIE —10 -RET -TA EAUM . The remains were received Cremation Permit No.1 7-73180-5070 Issuedat INDIAN RIVER COUNTY Date of Death MARCH 22 2 017 Date of Cremation '17 ByT� Cremator seawinds Crematory 735 South Fleming Street, Sebastian, Florida (772)589-1933 For Seawinds funeral Home We certify this container contains the Cremated Remains of ROBERT BAUM who died on November 13, 2016 in the City of Sebastian, County of Indian River, and State of Florida. Your loved one was cremated on 16-73378-5265 1 �S Permit # . Tag# " Cremator Date Of Cremation Thank you for allowing us to serve your family. CITY OF SEB, �µ. HOME OF PELICAN ISLAND Certificate No. 2530 MI. OF SEBBASM Certificate of Interment Rights IN ACCORDANCE with provisions of the Code of Ordinances of the City of Sebastian, it is hereby certified that: Robert E. Baum & Marjorie L. Baum 1035 Graces Landing Circle Unit 104 Sebastian, FL 32958 In and for consideration of the sum of $1,200.00 is entitled to full interment rights in the Sebastian Municipal Cemetery for the following niche: Unit 4, Blk 31, Niche 53e of the Sebastian Municipal Cemetery, as maintained on file in the records of the City Clerk for use in accordance with the conditions, ordinances, resolutions, rules and regulations prescribed therefore by the City of Sebastian. CONVEYED THIS 27th day of March, 2017. CITY OF SEBASTIPN, FLORIDA Joseph F. Griffin City Manager ATTEST: 4�� " '4� eanette Williams, MMC City Clerk CITYOF SEB�ASTSAN HOME OF PELICAN ISLAND 1225 Main Street Sebastian, FL 32958 (772) 589-5330 Phone (772) 589-5570 Fax April 7, 2017 David Baum 247 Lillianite New Braunfels, TX 78130 RE. Interment Rights to Unit 4, Block 31, Niche 53e, Sebastian Municipal Cemetery Dear M. Baum, Enclosed is City of Sebastian Certificate 2530 entitling you to full interment rights in Unit 4, Block 31, Niche 53e, in the name of Robert E. & Marjorie L. Baum. If you have any questions, please contact our office at 388-8209. Sincerely, i Cathy Te to Records Clerk Enclosure Ora SEBASTIAN � 36 HOW OF PELICAN ISLAND City of Sebastian Municipal Cemetery Purchase Receipt To enable the City of Sebastian to determine the correct rate, and in accordance with cemetery rate regulations, proof of City residency of purchaser or person for whom lot is intended for interment must be provided at time of purchase. Na T W ress q y ( Area Code & Phone Number �� R1 E L • .L��i,u.n�1. t 1�1�'z-T � /�j,4-c.ctti Name & Residence Address of Intended Occupant if Other Than Purchaser OFFICE USE ONLY Receipt is acknowledged in the sum of: W0'+h6ttSaA01 GuFt hL ryte —Dollars($ a oo ) on this a94"I day of '7Y�&Rd-N 20_L�Z for the purchase of the following described Cemetery Lot(s) and/or Niche(s). Unit +, Block 3 ( , Lot(s) Niche(s) 53 2 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 & Installation Interment $SD. 0 /W O H Circle One Disinterment L2z4, 0a TOTAL Signature of Purchaser City of ebastia I:\W W-DATAWs-CemeterARECEIPT.doc 2� The following documents were provided as Proof of Residency: Funeral Director's Request to City of Sebastian for Burial Opening in Sebastian Municipal Cemetery Funeral Homer Address:_ Phone: (Check) Open Burial Lot Open Cremains Lot NhL Open Columbarium Niche rTrp— Contact Information: Kip Kelso, Cemetery Sexton Sebastian Municipal Cemetery Phone(772)589-2545 Fax (772) 228-9927 City Clerk's Office Cathy Testa City Hall, 1225 Main Street Sebastian, FL 32958 Phone (772) 388-8209 ctestaocityofsebastian.org Lot Block_ Unit_ Lot_ Block_ Unit— Niche =-)�) nit_Niche=(�) Blocker Unit (Circle) N S E W .;urial Date and _reased4. • . . G: -%l I v Name and Signature of Lot Owner or Representative: (Mint provide pro er documentatio of w sal j 7 �� 7 1 Aat m 'Print Name Signature Date that I have determined the ownership of the above described site that all site fees and strative fees have been paid and authorized opening of same. and Signature of Licensed Funeral Director: Print Name Signature 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 Sexton Certification: ' Ce to S xton Date This form to be provided to Clerk's Office by Sexton for permanent record upon completion, DAVID T BAUM OR YONG MEE KIM 2293 COMMON ST APT 49 NEW BRAUNFELS, TX 78130-3130 ?'/)mA 20v7 Lute 7311 30-7426/3140 $ v -Dollars o� " CITY OF SEBASTIAN 10426 ADMINISTRATIVE SERVICES RECEIPT Name -BA11ti-i . LJ Cash Date 3 �a17, % [Check # --7;3I ❑ Credit Amount Paid 001001 208001 Sales Tax 001001 220000 Security Deposit 001501 362100 Taxable Rent 001501 362150 Non -Taxable Rent 450010 369900 Airport Badge 001001218010 CobraServe 001501 354100 Code Enforcement Fines 001501 347557 Community Center Revenue 001501341920 Copies 001501 351140 Parking Citation 001501 342100 Police Security Services 001501 329200 Site Plan Review 001501 329300 Subdivision/Plat Review 001501 329100 Zoning FeetO s a I SC�1 3`�3s ©I G -A Total PaidrOf , IN Is Security Dep Held -Amount$ Check # White - Dept. of Origin • Yellow - Admin. Svcs. • Pink - Applicant /vI//V 7 Z� 14 YVI 247 Lillianite New Braunfels, TX 78130 ,- 7/- 5 op- / f6