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HOME OF PELICAN ISLAND
Certificate No. 2105
Certificate of Interment Rights
IN ACCORDANCE with provisions of the Code of Ordinances of the City of
Sebastian, it is hereby certified that:
John H. Brown
(name)
626 Fleming Street, Sebastian, FL 32958
(address)
in and for consideration of the sum of $2,100.00 is entitled to full interment rights in
the Sebastian Municipal Cemetery for the following plots:
Unit 4_ Block _9_ Lots_18,19, 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 30th day of November, 2006.
OF
' A~ Minner
City Manager
FLORIDA
ATTEST:
--~---
Sally A. Maio, MMC
itv Clerk
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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
John H. Brown
Names)
62 Fleming Street, Sebastian, FL 32958
Address
Area Code & Phone Number
Howard E. & Joan M. Brown, 1210 W. Hyacinth Circle, Barefoot Bay, FL 32976
Residence Address of Intended Occupant if Other Than Purchaser
Office Use Only
Receipt is acknowledged in the sum of:
Two thousand, One hundred and no/100-----------------DOIIarS(~2, 100.00 )
on this 30th day of Nov • , 20 06 for the purchase of the following
described Cemetery Lot(s) and/or Niche(s).
Unit ,Block 9 ,Lot(s) 1s, 19, 20 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:
Corner Markers (set of 4 - $20) Opening & Closing
Vase and Ring for Niches (cost) Interment 75.00
Signature of Purchaser
W O H
Circle One
TOTAL $ 2175.00
J,,
I y of Sebastian
Service fees are to be paid at time of need only
Disinterment
I :\W W-DATA\Ms-Cemetery\RECEI PT.doc
RY OF SEBASTIAN
CRY CLERK'S OFFICE 3 6 91
RECEIPT
Name Brown
~_~„ Nov. 30, 2006
No.
001001 208001
001501 322900
001501 341920
001501 341910
001501 341930
601010343800
001501 343805
^ Cash
~Check# 2274
Amount Paid
Sales Tax
Garage Sales
CopieslBid Specs.
LDCICode of Ordinances
Electlon Qualifying Fees
Cemetery Lots
LotMiche 18,19,2pglock 9 .Unit 4
Cemetery Fees
2,100.00
Total Paid 2 ,100.00
Inkials
White -Dept. Origin • Yellow -Finance • Pink -Applicant
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JOHN H. BROWN
626 FLEMING STREET
SEBASTIAN, FL 32958
The Order Of ~+ ~ r Y ~^ V /'~ R
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~~~ HARBOR, FEDERAL
~g INDIAN RIVER COUNTY DIVISION
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;~: 267084 i99~: 208000 L4558601 2274
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