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Certificate No. 2119
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SEA,
HOME OF PELICAN ISLAND
of Interment Rights
IN ACCORDANCE with provisions f the Code of Ordinances of the City of Sebastian,
it is hereby certified that:
Kenneth E. & Alice Fay Douglas PO ox 1394, Sebastian, FL 32978
(name) (address)
in and for consideration of the sum of $1,350.O~s entitled to full interment rights in
the Sebastian Municipal Cemetery for the following t:
Unit 3 Block COL Niche 47Ds
of the Sebastian Municipal Cemet ,
as maintained on file in the records of the ' _ Clerk
for use in accordance with the conditions, ordinances, resolutions, les and regulations
prescribed therefore by the City of Sebastian.
CONVEYED THIS 12th day of March, 2007.
CITY OF ASTIAN, FLORIDA ATTES • ~
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vA~Minner Sally .Maio, MMC
City Manager ity Clerk
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HOME OF PELICAN ISLAND
1225 Main Street
Sebastian, Florida 32958
Phone (772) 589-5330 -Fax (772) 589-5570
E-Mail: city@cityofsebastian.org
December 6, 2007
Kenneth E. & Alice Fay Douglas, of 341 Biscayne Lane (Mailing PO Box 781394),
Sebastian, FL 32958 have surrendered to the City:
City of Sebastian Certificate of Interment Rights No. 2119 -Unit 3 Block Col Niche~47Ds
in even exchange for
City of Sebastian Certificate of Interment Rights No. 2155 -Unit 3 Block Col Niche 12Ds
By p ent of the ~,~1~ dim nistrative/transfer fee of $67.50
Sally A. io, MMC
City Clerk
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Kenneth E. Douglas
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Alice Fay D glas
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HOME OF PELICAN 15LAND
Certificate No. 2119
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Certificate of Interment Rights
IN ACCORDANCE with provisions of the Code of Ordinances of the City of Sebastian,
it is hereby certified that:
Kenneth E. & Alice Fay Douglas PO Box 1394, Sebastian, FL 32978
(name) (address)
in and for consideration of the sum of $1 50.00 is entitled to full interment rights in
the Sebastian Municipal Cemetery for the following lot:
Unit 3_ Block _COL_ Niche 47Ds_
of the Sebastian Municipal Cemetery,
as maintained on file in the records of the City Clerk
for use in accordance with the conditions, ordinances, resolutions, rules and regulations
prescribed therefore by the City of Sebastian.
CONVEYED THIS 12th day of March, 2007.
TIAN, FLORIDA
'" Al~ Minner
City Manager
ATTESTY .
Sally .Maio, MMC
,. ity Clerk
~'IY E}F
March 12, 2007
Mr. & Mrs. Kenneth E. Douglas
PO Box 781394
Sebasatian, FI 32978
RF.• Interment Rights to Unit 3, B/ock COL, Niche 47Ds, Sebastian Cemetery
Dear Mr. & Mrs. Douglas:
Enclosed is City of Sebastian Certificate 2119 entitling you to full interment rights in Unit
3, Block COL, Niche 47Ds. We also understand that you may want to exchange this
location to one in the new columbarium when it is complete. We will notify you when it
is available.
Also enclosed is a copy of the Rules and Regulations governing the Sebastian Municipal
Cemetery.
If you have any questions, please contact our office.
Sinc _ ~-
Sally A. M ~o, MMC
City Cierk
SAM:ar
enclosures
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~o~^ or 'EI»tC~! ~~~~rar
City of Sebastian Municipal Cemetery
Purchase Receipt
To enable the City of Sebastian to determine the correct rate, and in accordance with cemetery
rate regulations, residence of purchaser or person for whom lot is intended for interment must be
provided at time of purchase
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ame(s) ~i'ir/G ~/-.Q~ss.• ~?o .Boar ~'~~'. ~f.,e . ~ ~:.~
Address
Area Code & Phone Number
Residence Address of Intended Occupant if Other Than Purchaser
Ofifice Use Only
Receipt is acknowledged in the sum of:
tars ($ `L~.)
on this ~~~_day of~ , 2Q~~for the purchase of the following
described Cemetery Lot(s) and/or Niche(s).
Unity, Blocl~-=o_~,~(~)~'~7cl~s Idi~he(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) ~,i~~~ 1,--~- Interment
Signature of Purchaser
W O H
Circle One
Disinterment
Service fees are to be paid at time of need only
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