HomeMy WebLinkAbout4-31-57eName �-
Unit
Block 3
i
Lot
Date of Mark -out
e0 '0 - )
Date of Burial A,? I Ll 3 Timed : - /'I
Name of Funeral Home
Authorized by-f
Certificate No. 2112
Certificate of Interment Rights
IN ACCORDANCE with provisions of the Code of Ordinances of the City of Sebastian,
it is hereby certified that:
Carolyn Gribbroek 1049 Foster Avenue, Sebastian, FL 32958
(name) (address)
in and for consideration of the sum of $1,800.00 is entitled to full interment rights in
the Sebastian Municipal Cemetery for the following niches:
Unit —4— Block 31 Niches 57 & 58 East
of the Sebastian Municipal Cemetery,
as maintained on file in the records of the City Clerk
for use in accordance with the conditions, ordinances, resolutions, rules and regulations
prescribed therefore by the City of Sebastian.
CONVEYED THIS 13th day of February, 2007.
OF ASTIAN, FLORIDA ATTE
inner Sally j. Maio, MMC
City Manager ---City Clerk
0 or
SEBASTMN
HOME OF PELICAN ISLAND
City of Sebastian Municipal Cemetery
Purchase Receipt
To enable the City of Sebastian to determine the correct rate, and in accordance with cemetery
rate regulations, residence of purchaser or person for whom lot is intended for interment must be
provided at time of purchase
Name(s
I' • t
FL
Area Code & Phone Number
C7IPor.1jP, C. Cjri.bbroek.
Residence Addfress of Intended Occupant if Other Than Purchaser
Office Use Only
Receipt is acknowledged in the sum of:
(�. !�:20/z—n Dollars ($��DO. 00 )
on this 13* _day of rtbrtllrq , 2007 for the purchase of the following
described Cemetery Lot(s) and /or Niche(s).
Unit , Block 3 1 , Lot(s) Niche(s) 6 7 + 5& wsS
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) Interment _L5, f�0 Disinterment
W O H
Circle One
TOTAL $ L1 4 , 44
cx�
Signature of Purchaser Vty of Sebastian
Service fees are to be paid at time of need only
I: \W W- DATA \Ms - Cemetery\RECEIPT.doc
TC
UARIES
County Funeral Home
& Crematory, Treasure
Coast Chapel.
Carolyn Gribbroek
Sebastian
Carolyn Green Grib-
broek, 77, died June 14,
2013, in Vero Beach.
She was born in James-
town, N.Y., and lived in Se-
bastian for 30 years, com-
ing from her birthplace.
She earned her bach-
elor's degree from Ithaca
College and a nursing
degree from Jamestown
Community College, both
in New York.
She was retired after 20
years as a registered nurse,
her last position with the
Royal Palm Convalescent
Center, Vero Beach.
She was a member of
the Sebastian Christian
Church in Sebastian.
She also was a member
of the Sebastian River Art
Club in Sebastian.
Survivors include her
daughter, Jeanne Fallis of
Sebastian; sons, Robert
Gribbroek of Sebastian
and Kevin Gribbroek of
Baltimore; brother, Mal-
lory Green of Morganville,
N.C.; sister, Sherrol Rustaz
of Vero Beach; and four
grandchildren.
She was preceded in
death by husband, George
Coolidge Gribbroek; and
sister, Hannah Green.
Memorial contributions
may be made to VNA/
Hospice Foundation, 1110
35th Lane, Vero Beach, FL
32960.
Services: Services will
be announced at a later
date. Arrangements are
by Strunk Funeral Home
And Crematory. A guest
book is available at www.
strunkfuneralhome.coiri.
Vero Beach Crematory, LLC
1830 Wilbur Avenue
Vero Beach, Florida 32960
We hereby certify that these are the cremated human remains of:
Carolyn Green Gribbroek
June 14, 2013
(Date of Death)
Strunk
Funeral Home & Crematory
(Funeral Home in Charge)
03218
(Cremation ID Number)
I it ,, 1;
June 20, 2013
(Date of Cremation)
Sebastian, Florida
(City and State)
B`i�"/�
(Cremator Signature)
CITY OF SEBASTIAN
CITY CLERK'S OFFICE 4400
RECEIPT
Name k/--) h r oe 1 ❑ Cash
Z 1
Date ' . ") Check #
No. Amount Paid
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 7 & , Block 3, Unit
001501 343805 Cemetery Fees
��7V✓'1/ Total Paid
Initials
White — Dept. of Origin • Yellow — Finance • Pink - Applicant
FUNERAL DIRECTOR'S REQUEST TO CITY OF SEBASTIAN
FOR BURIAL OPENING IN SEBASTIAN MUNICIPAL CEMETERY
01c
SE
HOME Of PEUCAN ISLAND
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 -8215 or 388 -8214
Fax: (772) 589 -5570
STRUNK FUNERAL NOME & CRIMIATURY
FUNERAL HOME: 1623 No Contra! Aye. -
ADDRESS: SEBASTIAN, FL 32958
gggb
PHONE #:
(Check One)
OPEN BURIAL LOT Lot Block Unit
OPEN CREMAINS LOT Lot lock Unit
OPEN COLUMBARIUM NICHE Niche .Z)- Ylock 31 Unit —
N S E W
BURIAL DATE AND SERVICE TIME: p ,�,
FOR DECEASED: ar D I t1 y-t b t ri bb y-o &E -
Name t
NAME AND SIGNATURE OF LOT OWNER OR REPRESENTATIVE:
(Must provide proper documentation of ownership)
S� l �itcwnZ &r►bbYbmyaIt D 1 �3
Name Sign a a 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 DI ECTOR:
VV 1 t i 0, : W�1-I� G�1 Zt.Z_ U)
Name Signature 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 ondflhat all fees have been paid-
CediiteAt Se ton D to
This form to be provided to Clerk's Office by Sexton for permanent record upon completion