HomeMy WebLinkAbout4-10-31-~-
Certificate No. 2145
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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:
Brenda L. Drew 7035 Gullotti Place, Port St. Lucie, FI 34952
(name) (address)
In and for consideration of the sum of $2,000.00 is entitled to full
interment rights in the Sebastian Municipal Cemetery for the following
Lot(s)/Niche(s)
U n it_4_Block_10_Lot(s)_31_
of the Sebastian Municipal Cemetery,
as maintained on file in the records of the City Clerk
for use in accordance with the conditions, ordinances, resolutions, rules and
regulations prescribed therefore by the City of Sebastian.
CONVEYED THIS 13th day of August, 2007.
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FRIDAY, AUGUST 10, 2007 + SCRIPPS TREA
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KEVIN ROBERT
DREW
Mr. Kevin Robert Drew, 19,
former Vero :Beach resident.
died August 7; 2007 fn
Orlando, FL.
He was born December 31,
1987 in :Chicago, IL and
moved to Port St. Lucie; FL fn
2002, from Vero: Beach, FL.
Mr. Drew was a student at.
Universal Techrfcal Institute
in Orlando; FL; : he attended
Sebastian River Hfgh School
and was a graduate of'Port
St. Lucie High School, Class
of 2006. He was. a wrestler
.while in high school.
Survivors' include his
parertfs, Keith, and Brenda
Drew of Port 5afnt Lucie; FL;
Sandra and Roger Middle
brooks of Vero. Beach, FL;,
brothers, Adam Drew of Port .
Saint Lucie, FL, Steven
Drew of Honolulu', HI,
Michael Drew of Fellsmere,
FL, Phil1ip.Koster of Port
..Saint Lucie, FL, George
Middlebrooks of Knoxville,
TN; sisters; Sharon Drew of
lasonville, IN, Tara Drew of .
Sebastian, FL, Lauren Koster
of Port Saint Lucie, FL, Eliza
beth Middlebrook5 of
Nashville; TN; .grandmother,.
Delores and M'arvm Klein of
Fort Pierce, FL; .grandmother, .
Britt Morftz of New 'Port
Richey, FL
SERVICES: a visitation vriif
be held from' 12-3 p.m.
August il, 2007 at the Strunk
Funeral Hame, 1623 N.
Central Avenue; Sebastian,
FL 3295$,
A funeral service will
follow at 3 p.m., in the
funeral home chapel with
Rev. Tom Kempf officiating.
Interment will follow fn
Sebastian Cemetery,
Sebastian, FL
paid obifuary
FLAR[DA DEPARTMENT OF ~,~.
~~
HEALT State of Florida, Department of Health, Vital Statistics
APPLICATION FOR BURIAL -TRANSIT PERMIT
A• (TYPE)
1. Name of First Middle Last Date Month Day Year
Deceased of
Kevin Robert Drew Death Aug. 7 2007
2. Place of Death City, Town or Location Name of (If neither, give street address)
County Hosp. or
Orange Orlando Inst. Taft Vineland Rd ~ Bachman Road
3. Name of Medical Address Phone Number
Certifier Sara Irrgang, M.D., M.E. 1401 Lucerne Terrace
Medical Examiner Physician Orlando, FL 32806 407-836-9400
4. Name of Funeral Home/Diaet•Bieposal Address Fla. Lic. No./Reg. No. Phone No. (Area Code)
Establishment 1623 N. Central Ave.
Strunk Funeral Home Sebastian FL 329 g 1228 772-589-1000
5. Check a. ^ The medical certfication has been completed and signed. A completed certficate 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 wmplete and sign the medical
certification of cause of death within 72 hours.
c. ~ Ste hanie was contacted on $/g/07 He/she verified that
. 1 rr an ,Medical Examiner, will complete and sign the
I rtificati se of death within 72 hours.
6. Funeral Director! ign F.E. No./Reg. No. Date Signed
OireetBispc35er 44048
B. BURIAL -TRANSIT PERMIT
Permission is hereby granted to dispose of this body. Permit No. 1228-07-0334
A five (5) day extension of time for filing the death certificate (exGusive 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~eath section of the death certificate within
72 hours.
^No extension of time for filing the death certificate has been requested.
'a~"~ ^ Date Date Certificate
SubregistrarSignature c ~..!+• to ~ , ~~ Issued: 8/9/07 Due: 8/14/07
.-.
c. AUTHORIZATION for CREMATION, DISSECTION, or BURIAL-AT-SEA
Approval Number:
Date
Medical Examiner, ,gave authorization by telephone to
Funeral Din3ctor/Direct Disposer. Date
The Medical Examiners 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 Sebastian Cemetery
i~i BURIAL ^STORAGE Date of Disposition e}
^CREMATION
Signature of Sexton t
or Person-in-Charge J
^OTHER (Specify)
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.
Distribution: White: Cemetery or Crematory
DH 326, 8/97 (Obsoletes all previous editions) Yellow: Funeral Ovector or Direct Disposer
(Stock Number. 5740.Op0-0326-2) Pik: Local Registrar , ~ ~ ~
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August 13, 2007
Mrs. Brenda L. Drew
7035 Gullotti Place
Port St. Lucie, FI 34952
RE.• Interment Rights to Unit 4, B/ock 10, Lot 31 Sebastian Cemetery
Dear Mrs. Drew:
Enclosed is City of Sebastian Certificate 2145 entitling you to full interment rights in
Unit 4, Block 10, Lot 31.
Also enclosed is a copy of the Rules and Regulations governing the Sebastian Municipal
Cemetery.
If you have any questions, please contact our office.
Sin rely, ~j
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Sally A. aio, MMC
City Clerk
SAM:ar
enclosures
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H4ME 4F PELI~I 15[ANE1
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, proof of City residency of purchaser or person for whom lot is intended for interment must
be provided at time of purchase.
dC/~ EN`Di9 L . c~~LFu1
Name(s) _ ~
Address
77,~?- 33~ - X76 L
A er a Code & Phone Number
Name & Residence Address of Intended Occupant if Other Than Purchaser
OFFICE USE ONLY
Receipt is acknowledged in the sum of:
d~
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Dollars ($ ~d0~ OD
on this. /3,~ day of , 200'` for the purchase of the following described
Cemetery Lot(s) and/or Niche
Unit ~_, Block ~, Lot(s) .~/ 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 a.~~0 O / W O H
Circle One
Vase and Ring for Niches (cost)
Temporary Marker Preparation & Installation,
Signature of Purchaser
Disinterm
TOTAL $~ o~ef?~ o ~
City of Sebastian
The following documents were provided as Proof of
Residency:
Interment
1:1WW-DATAWIs-CemeterylRECEIPT.doc ! and
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BRENDA L. DRE~~t c-G,
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August 13, 2007
Mrs. Brenda L. Drew
7035 Gullotti Place
Port St. Lucie, FI 34952
RE.• Interment Rights to Unit 4, B/ock 10, Lot 31 Sebastian Cemetery
Dear Mrs. Drew:
Enclosed is City of Sebastian Certificate 2145 entitling you to full interment rights in
Unit 4, Block 10, Lot 31.
Also enclosed is a copy of the Rules and Regulations governing the Sebastian Municipal
Cemetery.
If you have any questions, please contact our office.
Sin rely, ~j
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Sally A. aio, MMC
City Clerk
SAM:ar
enclosures