HomeMy WebLinkAbout4-09-21HOME OF PELICAN ISLAND
Certificate No. 2110
CI'I'~ ~ ~I
Certificate of Interment Rights
IN ACCORDANCE with provisions of the Code of Ordinances of the City of Sebastian,
it is hereby certified that:
Aida Moore 574 Alamanda Avenue, Sebastian, FL 32958
(name) ~ (address)
in and for consideration of the sum of $700.00 is entitled to full interment rights in the
Sebastian Municipal Cemetery for the following lot:
Unit 4 Block 9 Lot 21
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 7a' day of February, 2007.
CITY F SEB TIAN, FLORIDA ATTEST:
er Sally .Maio, MMC
ty anager ity Clerk
CITY OF SEBASTIAN
4y
~a~'~
~~
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CITY CLERK'S OFFICE ~ Q O
RECEti~T ~!
Name ~ - r ~ C. ~G~ ~ ^ Caah
Date. :~C ' 7 ~ ~.~ ~CheckS~
No. Amount Paid
001001208001 Sales Tax
001501322900 Garage Sales
001501341920 Copk+slBkl Specs.
00,50, 34,9,0 LDC/CodeofOrdinarlces
001501341930 Election Guatify(ng Fees
601010343800 Ceme~ry Lots . ~t ~
r
LotMkshe ~ 1 . Bkx~C ~_, Unit
001501343 ~~
~'~~
805 Cemetery Fees
-
Total Pak! ~~~
Initials
Whits -Dept Oriotn • Yellow -Finance • Pink • Appliant
r
CLEMENTE D. PERPETUA OR 2989 1
PHYLLIS E PERPETUA
574 ALAMANDA AVENUE >63-4/630 F~
SEBASTIAN, F 2958 Date`s/Q 7 1084
Pay .,
to the order'of r 7~
S~y~NI~~Nd~edS'~f/eyT f ~~L° ~//0~/ZS' Dollars ~ o..;
BankofAmeric ~~'
''. AGH R/T 063100277: _ ~,
Memo ~l4Z'%9f) - ,~~.
x:06 300004 7t: 00 3 3B86 2 7 5 20ii' 2989 ~
L _ _;
Name ~ ~'.1
Unit ~/~
Block
Lot
Date of Mark-out `~ r
Date of Burial '~~ ,{ ~ / ' Time ~~' %?~% _{ ~ ~~~
/~µ
Name of Funeral Home ~f l~ a~ s~'''~ '
Authorized by
~..~~~~~
John ~Morgarr Jr.
John Morgan , Jr., 60,, of`
B,arefoot,Bay,-died, .Feb. 1,
-2007, -at Holmes Regional
Medical. `Center, Mel-
bourne;
He was born ,March 14,
`1946, in_New;York ,-City,
N.Y., .and, moved to Bare-
foot Bay four years ,ago'
fromMiarrii.
Mr: Morgan was a coin:
colTeetor for the New Yorl4
Telephone Company." He
Served iri the U.S.' Navy
d`uringVietnam:
He is survived by a sister,`
Aida 'Moore„ ~ of Barefootp
Bay.
A visitation was , held;
from 5 to`'6 p.m; on Feb 5,:,
at" the .Strunk Funeral
Home, Sebastian. ~`
~AIvlass, of,Christian~Bur-
ial ; waS''celebrated ' at" 11
a.m., Feb. 6, at Saint ,
Sebastian. .;,Catholic
Church, Sebastian. Burial
followed at Selia~ian
`Cemetery with fill mili- j
tart' honors; conducted by
the Sebastian .River Area
Veterans' honor guard.
BAREFOOT BAY
John Morgan Jr. --
John Morgan ' Jr., G0 I~
died Feb. 1, 2007, at
Holmes Regional Medical Cen-
ter in Melbourne.
He was born in New York ''
City and lived: in Barefoot Bay I
for four years, coming from
`Miami.
He had been a coin collector . ',
for. the New York `Telephone
Co. ,
He served in the Navy dur-
ing the Vietnam War:
Survivors include his sister,
Aida Moore of Barefoot Bay.
SERVICES: Visitation will be
from 5 to 6 p.m. Feb. b at ;I
Strunk` Funeral Home in, Se-
bastian. ' A Mass of Christian
burial will be"celebrated at 11
a.m. Feb. 6 at St. Sebastian ',
Catholic Church. Burial with
full'military honors; will follow
in Sebastian Cemetery.'
FLORID DEPARTM OP
LTL+CIL~ State of Florida, Department of Health, Vital Statistics
II11~~ APPLICATION FOR BURWL -TRANSIT PERMIT
A. (TYPE)
1. Name of First Middle Last Date Month Day Year
Deceased of
John Morgan, Jr. Death Feb. 1 2007
2. Place of Death City, Town or Location Name of (If neither, give street address)
County Hosp. or
Brevard Melbourne Inst. Holmes Regional Medical Center
3. Name of Medical Address Phone Number
cert)fier Charles Croft, M D. 1402 Oak Street
Medical Examiner Physician Melbourne, FL 321-722-3288
4. Name of Funeral Home/~t ~~ 1623 N . Central Ave. Fla. Lic. No./Reg. No. Phone No. (Area Code)
Establishment Sebastian, FL 1228 772-589-1000
Strunk Funeral Home
5. Check a. The medical certific~fion has been oompleted and signed. A completed certfficate of death accompanies this
Appropriate application. -
Box
b, ~ Susan was corrtacted on 2 /2 /07
He/she verified that this death was from natural causes, that them was no accident nor other external cause of death,
and that Dr. Croft will complete and sign the medical
certification of cause. of death ithin 72 hours.
c. ~ was contacted on He/she verified that
Medical Examiner, will complete and sign the
cause of death within 72 hours.
6. Funeral Director! ig F.E. No./Reg. No. Date Signed
[;Kroef•Bisposer 1862 2 /2 /07
B. BURWL -TRANSIT PERMIT
Permission is hereby granted to dispose of this body. Permit No. 1228-07-0045
A five (5) day extension of time for filing tha death certificate (exdusive of weekends) has been requested and granted since the physician has
been contacted by the funeral director and will not be able td complete the medical certification of cause-of~eath section of the death certficate within
72 hours.
~No extension of time for filing the death certificate has been requested.
~, Date Date Certificate
Subregistrer Signature Issued: 2 / 1 /07 Due: 2 /6 /07
c. AUTHORIZATION for CREMI~4TION, DISSECTION, or BURIAL-AT-SEA
Approval Number. Date
Medical Examiner, ,gave authorization by telephone to
Funeral DirectodDired Disposer. Date
The Medical Examinees approval must be obtained before disposal by any of the above methods. Awaiting period of 48 hours after death is
required for all cremations.
D. CEMETERY OR CREMATORY
Method of Disposition: Place of Disposition -`~=~`~"- -Seb~S-t~t~.= Cemeter'y
BURIAL STORAGE Date of Disposition ~ ~~p ~.
CREMATION OTHER (Spedfy)
Signature of Sexton
or Person-in-Charge
This permit must be endorsed by the Sexton or
within 10 days to the local County Health Depai
~ iii r~~~ - ~_
~-in-charge (or by the Funeral Diredor/Dired Disposer when there is no
ln.the county where disposition occurred.
and
DH' 328, 8197 (ObwNtss sU prsviow editions) ~utr~Aan. YaNwr Flr~e~l DYactor ~Dtect Di~poMr
(S~dc Wtrnber: 5740000-0326-2) ~: Local Repietrar y ~ ~ ,~