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HomeMy WebLinkAbout4-28-14°'~ GEF.+I Index:RECORD # NEwCEM Record:1878 Last Name Address i Address 2 City Deed # Unit # Lat Number Lot Number Lot Humber Lat Number Comment Comment CF>wrd City of Sebastian, FL - Cemetery Lots Razzini First Name John L.& Euelyn Sebastian State F1 dip Date Amount 4- Block # 28 14 Interred Euelyn Razzini 15 Interred Jahn L. Razzini Uet Interred Interred See 32958- Dte Interred 03-07-02 Dte Interred 07-13-98 Dte Interred Dte Interred CE>dit CD}elate CN>ext CP>reu CR>e-search CL}abel CT>ag CEsc? Tuesday, Apr 26, 2005 03:11 PM ,:. .,. ; . !4._ ~ Name "~ " ~~ Unit Block ~ ~') Lot ~~ Date of Mark-out ~/~f/~~ ,~~~ O `Ti' Time ~~ "~`~ Date of Burial .~/--- Name of Funeral Home ~ / ~` _~ ~ ~` / i Authorized by ~ ' ~'` '~• ~' , ~..~ T N S ~ ~ ~ 3£~ o ~~'° ~ ~ ~ © rA © ~ Q J r 0 O _fmm '1 W Q 2 ;, ,a 'O ._ ti ti `9O ru O Z Q v ~ ~- a N a m [~- u, I< N W ~ W N o ti ~~ / .., I[i S/ Z N j{ .a ^ _ Z N LL N ( ~ ~ O . ~V O ` ~~ ~ Warm ZuJ °'o= ~ (! l adz ru ~-m~ oca ~ y iiy m = a u v = IU ^Z d L ~~~~ ~ '. ~~~~ w >-~o O a°o ~' de un~_ aµe an.o~®~ n~~vs ®r+vioevn~ ,~. CITY OF SEBASTIAN ~ ' ~- CITY CLERK'S OFFICE RECEIPT y - , o cash Name - Check #~ m~ ~~ h Date AmountPaid ~~ 001001 208001 Sales lax ~-- 001501 322900 Garage Sales ~- 001501 341920 CopieslBid Specs. _~~ 001501 341910 LDCICode of Ordinances ~- 001501 362100 Community Center Rent ~--- 001501 362100 Yacht Club Rent _-- 001501 362150 Non Taxable Rent 001501 343800 Cemetery Lots ---- 601010 343800 Cemetery Lots .~ Q ~~/ Block ~~ Unit ~- Lot/Niche _L.L-~ 001501 369400 Interment Fee __-- 001501 369400 Weekend Service ~- 680800 220681 Yacht Club Security Deposit osit -~- 680800 220682 Community Center Security Dep osit ~~ 680800 220683 Riverview Park Security Dep _- ___--- __ _-- Total Pald _L~u- Initials White -Dept. of Origin • Yellow -Finance • Pink - ApPlican FLORIDA DEPARTMENT OF HEALT A. (TYPE) State of Florida, Department of Health, Vital Statistics APPLICATION FOR BURIAL -TRANSIT PERMIT %~ ~ a~ r~ y 1. Name of First Middle Last Date Month Day Year Deceased °f Evelyn Catherine Razzini Death March 2 2002 2. Place of Death City, Town or Location County Indian River Vero Beach Name of (If neither, give street address) Hosp. or Inst. Palm Garden of Vero Beach 3. Name of Medical Address Phone Number Certifier R Mittleman 2500 S. 35th Street Medical Examiner Physician Fort Pierce, FL 772-464-7378 4. Name of Funeral Home/Direct Disposal Address Fla. Lic. No./Reg. No. Phone No. (Area Code) Establishment 1623 N. Central Ave. Strunk Funeral Home Sebastian FL 1228 772- - 5. Check a. ~ The medical certification has been completed and signed. A completed certificate of death accompanies this Appropriate application. Box b. ~ was contacted on He/she verified that this death was from natural causes, that there was no accident nor other external cause of death, and that will complete and sign the medical certification of cause of death within 72 hours. c. ~ ~ was contacted on He/she verified that s" ~ ,Medical Examiner, will complete and sign the medi al rtifidatioy>'of c e of death within 72 hours. 6. Funeral Director/ Si tlxe F.E. No./Reg. No. Date Signed p;~,~. 1862 3/4/02 B. BURIAL -TRANSIT PERMIT Permission is hereby granted to dispose of this body. Permit No. 1228-02-0096 ~A five (5) day extension of time for filing the death certificate (exclusive of weekends) has been requested and granted since the physician has been contacted by the funeral director and will not be able to complete the medical certification of cause-of-death section of the death certificate within 72 hours. No extension of time for filing the death certificate has been requested. .m.,, Date Date Certif'cate Subregistrar Signature ~ . ~~~ Issued: 3 ~ ~- ~ ~ 2. Due: ~~'] f ~ ~.,, c. Approval Number: Date Medical Examiner, ,gave authorization by telephone to Funeral Director/Direct Disposer. Date The Medical Examiner's 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 Method of Disposition: BURIAL ~ STORAGE CREMATION ~ OTHER (Specify) Signature of Sexton or Person-in-Charge ~~ This permit must be endorsed by the Sexton or person-in-charge (or by the Funeral Director/Direct Disposer when there is no Sexton) and returned within 10 days to the local County Health Department in the county where disposition occurred. AUTHORIZATION for CREMATION, DISSECTION, or BURIAL-AT-SEA CEMETERY OR CREMATORY Place of Disposition Sebastian Cemetery Date of Disposition / ~`~ `~~, Distribution: White: Cemetery or Crematory DH 326, 8/97 (Obsoletes all previous editions) Yellow: Funeral Director or Direct Disposer (Stock Number: 5740-000-0326-2) Pink: Local Registrar