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HomeMy WebLinkAbout4-17-37CITY OF SEBASTIAN CITY CLERK'S OFFICE RECEIPT f Nam ~ ~ ~:. ~ ~. ~=„~ _-'' ^,,rC~as~. Date -'~' ." ~: ~.. -.,..-- -p''cneck# ~ ~~-: ,~.; No. Amount Paid r f"~ 001001208001 Sales Tax ``--~ '~; 001501322900 Garage Sales. ~,,, 001501341920 CopieslBid Specs. 001501341910 LDCICode of Ordinances 001501341930 Election Qualmring Fees 601010343800 Cemetery Lots ~ ~ ,~fy'`' LotMicfte "' ~ -~ ' ~ ~ Bkx~c ~~ Unit 001501343805 Cemetery Fees /~ .- Total Paid f~~%`• ' l Initi White -Dept. of Origin • Yellow -Finance • Pink -Applicant ~~/ ,,~?`"" " k/~-~Q ~~P 't` ~~ ~~~ ~.~~r~ -- FUNERAL DIRECTOR’S REQUEST TO CITY OF SEBASTIAN FOR BURIAL OPENING IN SEBASTIAN MUNICIPAL CEMETERY For information contact: Kip Kelso, - Cemetery Sexton Sebastian Municipal Cemetery Phone: (772) 589-2545 Fax: (772) 228-9927 City Clerk’s Office ~ Cathy Testa City Hall, 1225 Main Street Sebastian, FL 32958 Office (772) 388-8215 or 388-8214 ctesta@cityofsebastian.org FUNERAL HOME: ADDRESS: PHONE#: (Check One) XXXX OPEN BURIAL LOT Lot__37___Block__17 Unit 4 OPEN CREMAINS LOT Lot Block Unit OPEN COLUMBARIUM NICHE Niche Block Unit N S E W BURIAL DATE AND SERVICE TIME: FOR DECEASED: Name NAME AND SIGNATURE OF LOT OWNER OR REPRESENTATIVE: (Must provide proper documentation of ownership) Rosana Perez Rosana Perez 04/25/2018 Name Signature Date 171 South Orange Street, Fellsmere, Florida, 32948 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 DIRECTOR: 04/25/2018 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 and that all fees have been paid: Cemetery Sexton Date This form to be provided to Clerk’s Office by Sexton for permanent record upon completion. Strunk Funeral Home and Crematory 1623 North Central Avenue, Sebastian, Florida, 32958 772-589-1000 Monday, 4/30/2018, 11:00 AM Mass at Our Lady of Guadalupe Mission will arrive at cemetery around 12:30-12:45 PM Enriqueta Guevara McCoy Tim Marvin Tim Marvin ~4~ °~ C~ ®q 4~: CITY OF SEBASTIAN CHECK REQUEST Accounting Use Only Input Date 8/2/2007 Fiscal Period Document # Entered By Document Amount # of Lines Total HC Hash Due Date To Be Completed By Department 8/10/2007 Single Check Y / N Y Vendor Number LN TC Reference Organization Code Object Code Project Code Amount 601011 534959 $1,400.00 Description Number of Lines Amount $1 400.00 Buy back interment ri hts to cemete lots described as Unit 4, Block 17. Lots 37 & 38. Co y of Certificate # 2020 attached. 5% administrative fee does not appl as lots were urchased rior to 7/25/07. ISSUE CHECK TO NAME Robert E. and Karin M. LaCerda ADDRESS 461 Avocado Avenue CITY Sebastian State FL ZIP CODE 32958 DRAW CHECK FROM EE',BELOW APPROVED BY DATE 8/2/2007 BUDGET APP O © MAIL ATTACHED DOCUMENATION (Except for remit slips, requesting department should attach a copy of documentation along with the original) OTHER INSTRUCTIONS Please make copy of check for clerk files -Thanks ~~ ~ - ~~" -~ ~;.. HOME oF' PELICAN ISLANp C~OG'17 City ®f Sebastian Municipal Cemetery Purchase Receipt To enable the City of Sebastian to determine the correct rate, and in accordance with cemetery rate regulations, residence of purchaser or person for whom lot is intended for interment must be provided at time of purchase Name(s) ~f /~f/ ~C Address " _77z - ~/- o,~~y/ Area Code & Phone Number Residence Address of Intended Occupant if Other Than Purchaser Office Use Only Receipt is acknowledged in the sum of: .C~ il)/AQ J/ Dollars ($ oo. o ) on this .~,~ ~ day of , 20 as'~for the purchase of the following described Cemetery Lot(s) and/or fiche(s): Unit ~_, Block ~, Lot(s) 37~ .38 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 W O H Circle One Disinterment $ oo . ~ o Signature of Purchaser of Sebastian Service fees are to be paid at tune of need oni~ I:1W W-DATA1Ms-CemeterylRECEI PT.doc / ~ \~1 __-_ _ -. - _- _ _ _~ _ ___-- - - - __ -_ _ `..J G~ ~~~4 Qtt SEBAS7'L~ ...~ ~~• HOME OF PELICAN ISWVD Q (~j f ~~ d Certificate No. 2020 ,~~ ~. i I' CITE OF S~~~k.~Tf~.N Certificate of Interment Rights IN ACCORDANCE with provisions of the Code of Ordinances of the City of Sebastian, it is hereby certified that: Robert E. La Cerda and/or Karen M. La Cerda 461 Avocado Avenue, Sebastian, Fl 32958 (name) (address) in and for consideration of the sum of $1,400.00 has purchased and is entitled to full interment rights in the Sebastian Municipal Cemetery for the following plot: Unit 4 Block 17 Lots 37 & 38 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 23rd day of May, 2005. CITY OF SEBASTIAN, FLORIDA James A. Davis Interim City Manager AT~ST: t ~~ _~ Sally .Maio, MMC City Clerk O - - - _ _ _ U ~~\ O (~ ' ~ lam/. CIfY 6F ~';~~'Y` ~... HOME OF PE[.IUN ISU\ND Certificate No. 2020 'IT"~ 0~~' 5~~~~S~T'I~h;_N Certificate of Interment Rights IN ACCORDANCE with provisions of the Code of Ordinances of the City of Sebastian, it is hereby certified that: Robert E. La Cerda and/or Karen M. La Cerda 461 Avocado Avenue, Sebastia~z, FZ 32958 (name) (address) in and for consideration of the sum of $1,400.00 has purchased and is entitled to full interment rights in the Sebastian Municipal Cemetery for the following plot: Unit 4 Block 17 Lots 37 & 38 of the Sebastian Municipal Cemetery, as maintained on file in the records of the City Clerk for use in accordance with the conditions, ordinances, resolutions, rules and regulations prescribed therefore by the City of Sebastian. CONVEYED THIS 23rd day of May, 2005. CITY OF SEBASTIAN, FLORIDA AT~'EST: f 'f'~,. ~~ ~ ~ .' James A. Davis _ Sally .Maio, MMC Interim City Manager City Clerk .~ ~, ~~ r,~„~`~. ._~.,,~; . PEL[CAN ISL!WD HOME OF City of Sebastian Municipal Cemetery Purchase Receipt To enable the City of Sebastian to determine the correct rate, and in accordance with cemetery rate regulations, residence of purchaser or person for whom lot is intended for interment must be provided at time of purchase me(s) eS~Q_ .~NA~~oiG ~~ ~~ ~~9 ~~ Address ~ " 77z - ~i- o,~~~ Area Code & Phone Number Residence Address of Intended Occupant if Other Than Purchaser Office Use Only Receipt is acknowledged in the sum of: ~ ~- Dollars ($ oo. ) v on this .>?,3 ~ day of _ , 20 os'~for the purchase of the following described Cemetery Lot(s) and/or fiche(s). Unit ~, Block ~, Lot(s) 37a .38 Niches 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) Vase and Ring for Niches (cost) Opening & Closing Interment Disinterment W O H Circle One $ oo . 0 0 Signature of Purchaser of Sebastian Service fees are to be paid at tune of need oni~ I:1W W-DATA\Ms-CemeterylRECEI PT.doc CITY OF SEBASTWN CITY CLERK'S OFFICE ~ ~ ~ -~ RECEIPT ~1+ Namai~ ~.~ev ^ Cash Date OCS~ heck # O 8 No. Amount Paid 001001208001 Sales Tax ~ t '~ `~ 001501322900 Garage Sales ~`` 001501341920 Copies/Bid Specs. " 001501341910 LDC/Code of Ordinances 001501341930 Election Qualifying Fees ~/' 601010 343800 Cemetery Lots ~/ LoUN(ch~3~, ~ Block ~, Unit ~_ 001501343805 Cemetery Fees ' Total Paid Initi s White -Dept. of Origin • Yeliow -Finance • Pink • Applicant QiY Of ~~~~ ~L~ ~t HOME Of FEL.ICAN ISLAND 1225 Main Street, Sebastian, Fl 32958 Telephone (772) 589-5330 -Fax (772) 589-5570 May 24, 2005 Mr. & Mrs. Robert E. La Cerda, Sr. 461 Avocado Avenue Sebastian, Fl 32958 Dear Mr. & Mrs. La Cerda: Enclosed is City of Sebastian Certificate 2020 for the purchase of Cemetery Lots 37 & 38, Block 17, Unit 4. Also enclosed is a copy of your receipt and the Rules and Regulations governing the Sebastian Municipal Cemetery. If you have any questions, please contact our office. Sincerely, Sally A. Maio, MMC City Clerk SAM:ar enclosure