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Home My WebLink About3-COL-12CRYOF �� T.,. .��•r. : HOME QF PEUCAN ISLAND Certificate No. 2155 r- � r� (� �'� �j� � � �e�� `--'-' �--� _-�"� . �� ._ ) ��_ r� ►� 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 341 Biscayne Lane, Sebastian, FL 32958 (name) (address) In and for consideration of the sum of $1,350.00 is entitled to full interment rights in the Sebastian Municipal Cemetery for the following niche: U nit_3_Block_COL_Lot_12/ D/S/A_ of the Sebastian Municipal Cemetery, as maintained on file in the records of the City Clerk *paid previously for niche 47Ds - exchanged for 12DSA on 12/6/07 ring and vase fees in additional amount of $49.44 paid previously for use in accordance with the conditions, ordinances, resolutions, rules and regulations prescribed therefore by the City of Sebastian. CONVEYED THIS 6th day of December, 2007. EBASTIAN, FLORIDA Kf'C n r�r Ci . Manager A T: ,,.� � �. ,f� .. — Sally Maio, MMC City lerk Name ��NlL Unit � Block �[11.6,- Lot � �� Date of Mark-out z i-Y1 ' Date of Burial .� L �� • Time • � Name of Funeral Home S�� !• � t�n S � _ _ . Authorized by 7 .��Z', OI / G a m . I v � 0 m' � � = f i � e�a m • � � � > °S', = � Y � » a 1 � ,� 0 � 0 A W (�T o °o 0 0 0° °o 0 o cr v, v, 0 0 0 0 � o � A A A N O ao cD cD c0 cN0 O O O O O O � � O � m C7 'D�, d N � � � � � � � z ' � � v, � �Tp r c`n � a o> y �� N 0, fn N � a � y T N � �° � � x Ci I � n ,f � d (I , . � N i.7�. � � � '� 3 N �j� o � � ,c�., 0 a � � ►.i 2 3 A I � � �� mmo m�m ��W �o>y T � T s A = m � , � � Kenneth E. Douglas Kenneth Douglas, 74, Sebastian, FL. passed away December 3, 2012 at the Cape Fear Valley Medical Center, Fayetteville, NC. He was born July 20, 1938 in Anthras, TN. He resided in Sebastian, FL. for the past 38 years having come from Raeford, NC. Prior to his retirement, He worked as a US Postal worker for over 20 years. Mr. Douglas also served in the United States Army with over 20 years of service, part of which was served during the Vietnam War, having retired after a{ong and extensive military career. He was a member of the DAV Honor Guard, APWU and the American Postal Workers Union. He is survived by his son, Gary E. Douglas, Prescott, AZ, daughter, Wanda Douglas-Vickers, Sebastian, FL, sister, Bernice Hollon, Lake City, TN, brother, Donald R. Douglas, Lake City, TN, 3 grandchildren and 1 great grandchild. He is preceded in death by his wife of 48 years, Alice F. Douglas and brother, Ronald L. Douglas. a e ear rem ao RTIFICATE OF CREMATI�N �� U� - wa s crem a ted on DECF.MBER 8, 2012 at the Cape Fear Crema�ory Stedman, North C�r�olina 0 CFC Number: 12-12-11346 A� horiz�ed � FUNERAL DIRECTOR'S REQUEST TO CITY OF SEBASTIAN FOR BURIAL Of'ENING IN SEBAS7IAN MUNICIPAL CEMETERY SE��►AN �� i�oti�f v� r[uc�N nuno For informat�on conlact: Kip KeJso - Cemetery Sexton SeUastian Mi�nicipa! Cemetery (772J 589-2545 FUNERAL HOME ADDRESS PHONE #: City Clerk's Office Cify Ha!!, ? 225 Main Street Sebaslian, FL 32958 OlficQ {772J 388-8215 or 388-8214 F�x: {772) 589-5570 ,S L� �...� �i✓d 3 (Check One) OPEN BURIAL LOT Lot Block Unit �PEN CREMAINS LOT Lot __ Block Unil �PEN COLUMBARIUM NICHE Niche�C� T`""lock_ Go�• Unit BURIAL DAl�E AND SERVICE TIME: �j �� //�oo�• �if G � FOR DECEASED: � �hlL • o iv�me �JAME AND SIGNATURE OF L07 OWNER OR REPRESENTATIVE: (Must provide proper docume�tat�or� oi ownership) W• /i �it • Name Signature Date I certify that i have determined the ownership of the above described site that all site fees and administrative (ees have been paid and authorize open+ng ot same NA(�1E AND SIGNATURE OF LICENSED FUNERAL DIREC�f CiR. � �} . Name Signat�ire -------------------------------------------------------------------------------------- Date Cemetery Sexton Certificalion I certify that I have checked the ownership inforn»t�on by viewing the owner's deed and confirming with Cle�k's oPfice <�nd that ail fees have been pald ' . / i /'L-. Cemet ry Sexto • Date This fon�� to be provided to Clerk's Office by Sexton for perrnanenf record upon complet�on. Name Unit_ Block Lot _ 0 O� • I � � 0 Date of Mark-out r'/, 5'� .' oa c�p- , Date of Burial t� • Time Name of Funeral me �r� ��✓ L� -�--5 Authorized by � G S m I 0 v � 0 ,O � . < m � � T 7 e° m • � 8 � � i � � � � d m o; � ^ . � �� (� °o � 0 A W � O CT o °o °o °o °o °o Z 0 o v+ v+ i�+ cn o 0 0 0 0 0 0 A A ? A N O W N Oo W CO t0 (O (O O O CJ N O O O O O O O � m o � mm O o c�i � 3 Z � c� C) � c� y m m o �j � �o � � � � n ao v� x T r `cn <° n m fD O N � (n y H � � � � � � a A _ (Tp = y � � c � � �� Z � m ( 1 �� c� � � d � N � � a 3 0 c M v c: n � '� �� m m O .�G � �y� � O y T � T S n = m � � � In Memory of Alice F. Douglas April 06, 1942 - May 10, 2010 Alice F. Douglas, 68 of Sebastian, FL passed away Monday, May 10, 2010 at VNA Hospice House in Vero Beach, FL. She was born Apri16, 1942 in Sampson County, NC and was a resident of this area for 31 years, coming from North Carolina. Mrs. Douglas was working in NC, FL Schools and Tennessee State Park. Survivors include her husband of 49 years, Kenneth E. Douglas of Sebastian, FL; son Gary E. Douglas of Las Vegas, NV; daughter Wanda J. Douglas of Sebastian, FL; brothers Donald K. Tutor of Sebastian, FL, Billy H. Tutor of Vero Beach, FL; sisters Jo Ann Serley of Leesburg, FL, Hazel Hanell of Raeford, NC, Sara Grinstead of Orlando, FL and three grandchildren. She was predeceased by her parents Edgar and Lula Tutor, four sisters: Kathy, Kathleen, Claire Mae and Mildred. Memorial contributions may be made to VNA Hospice Foundation, 1110 35th Lane, Vero Beach, FL 32960. A memorial service will be held at 1:00 PM, Saturday, May 15, 2010 at Seawinds Funeral Home Chapel in Sebastian, Flarida. Sep 04 2009 2:13PM COS CEMETERY 7722289927 p.2 FUN�RAI DIRECTOR'S R�QUES1 TO CITY �F SEBASTIAN FOR 6URiAL OPENING IN S�BA5TIAN MUNiCIPAt. G�METERY . S MOy�t q1 ►{GCAX KLWO For informalion contacl: • K�p Ke�so - Cemalery Sexlon S�bastlan Mtmlcipaf Ceme�ery (772) 688-2b45 C(ty C�erk's Oftice CityHe�l, �225 Matn Shaet Sebastlan, FL 32958 0lilce (TT2j 388-8af5 or 389•821� Fex: (7T�� 89-5570 FUNERAL HQME: ' i,�iyJDS I=UNE�-RL HOM�'! ADARES3: �135 S. FI�N I►�G Si S�B�ls7'!A N, FL 3 2Ci' S� PHONE #: �i____�� 9- I9 3 3 - (Checic One) �pPEN 3URIAL lOT Loi 81ock Unit _�7PEN CR�MAINS LOT l.ot �81oCk �iU�it ��jJPEN COLUMBARIUM NICHE Niche 12 8iock�Unit � W BURIAI DATE AND SERVICE �'1ME: O�� M Foa o�cEASEQ: t�tcc F� G-cA-S �vame NAM� AND SIGNATURE OF i.Q7 pWNER OR REPRES�NTA71V�: (Must p�ovide proper docume�tation oT owne►shi 1.P� .�� j �I.� '�i� Name , ture Date I ceruiy that 1 have �determined the ownership of the above desCribed &ite thal a�l site fees and administrativa feee have been paid and authorize openins oi s8�me NAME AND SIGNATURE.OF LIC�NSED FUNERAL DIRECTO . �- �,; s ..L l0 . 51�MeS '"�. G�.AN i D te Name- ----------- - ------- • -_--•-----•-•- -------- �gneture ... .._. ._...-----......--------•--------. ...--- Cemetery Saxton CertiFicativn� I ceRify that I have checked the ownership inforrt�at�an by viewing the owner'9 cleeti s�d confrrminc� with CI rk's of�lce an t ot ell fees have been paid � � D C ter ex n Qa�� 7his form to be provided to Clerk's Oitice by S�xton tor permanent tecord Upon completion. 1225 Main Street, Sebastian, FL 32958� (772) 589-5330 — Fax 772-589-5570 December 10, 2007 Kenneth & Alice Douglas 341 Biscayne Lane Sebastian, FL 32958 RE.• Interment Rights to Unit 3, Co/umbarium Niche 12D/S/,4 Dear Mr. & Mrs. Douglas: Enclosed is City of Sebastian Certificate 2155 entitling you to full interment rights in Unit 3, Columbarium Niche 12D/S/A. If you have any questions, please contact our office. Sincerely, Sally A. Maio, MMC City Clerk SAM/jw Enclosures �� i� HaME OF PEUCAN 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: Citv of Sebastian Certificate of Interment Riqhts No. 2119 - Unit 3 Block Col Niche 47Ds in even exchange for C:itv of 5ebastian Certificate of Interment Rights No. 2155 - l By p ent of the ,�,�1� dm nistrative/transfer fee of $67.50 1 � � , J� Sally A. io, MMC City Clerk C�-�' Kenneth E. Douglas ° � } Alice Fay D glas �' c"Cf�-1.��_�'� �t�.��-� Certifi �, % 2-- � �� 1 l} �� , � ..� ^ �__ ��... HOME OF PELICAN ISLAND �f�� °w��-� �� Certificate No. 2119 � i '. � ��;��!�%�� of Interment Rights �� J�, 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 x 1394, Sebastian, FL 32978 (name) (address) in and far consideration of the sum of $1 50.0 '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 • � �� G�� , �A�Minner Sally . Maio, MMC City Manager rty Clerk �iY a�� `i x�, � ti ra f {{ �� ,� �� ,%�..,��Fe.� ) f . k � �„�'"""� : °'�,...: r��'�......,...I�i,; � - � � -'_"'.._... j'-� �� : �:.! ��i�E �� I�['� �� ,.. x i � �''�Giii ,��:[`°��. '.�.��';?�i�te's"_ �°�.. ,��°y'� 'T° ` n �-+^�^g £'% "7 .� �.y ��.}5,a+^,,,�e "" �}�^�{, u : � f � i •^� E,,�^ n. - r^; e ��€.F. ?�.jk F`�.�. �, ! f �� +.f'.d.+''��,r.fL+` �' F `�".+.f\ �..'� � <° � ,JS,,,�°"�^..,�'.�°+`%�5..� March 12, 2007 Mr. & Mrs. Kenneth E. Dougias PO Box 781394 Sebasatian, FI 32978 Rf• Interment Rights to Unit 3, B/ock COL, Niche 47Ds, Sebastian Cernetery 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 ,,, �r �_� � ',, Sally A. M io, City Clerk SAM:ar enclosures �/� ` �'�e MMC cnv �� '° .�T��1 ��, . �_F . _ �.. ��_ �� : -. _ _ ,,�.�- HOME OF PEL{CAN ISLAND Certificate No. 2119 �� "�" ��' 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. 8� Alice Fay Douglas PO Box 1394, Sebastian, FL 32978 (name) (address) in and for consideration of the sum of $1,350.00 is entitled to full interment rights in the Sebastian Municipal Cemetery for the following lot: Unit 3 Block COL Niche 47Ds of the Sebastian Municipal Cemetery, as maintained on file in the records of the City Clerk for use in accordance with the conditions, ordinances, resolutions, rules and regulations prescribed therefore by the City of Sebastian. CONVEYED THIS 12th day of March, 2007. C TIAN, FLORIDA "" Al� Minner City Manager ATTEST;- . %' �-� �� , :� % f � ��; �� - ,�'`� � - i Sally . Maio, MMC � ity Clerk �7 �L i "�� p � �� 1 �, � '. ,� a;1,.�..J »..:� '' � "� i'= y�� S�I�Fb tjF PFLt� ��i.pJ'a� City of Sebastian Municipal Cemetery Purchase Receipt ', I � � To enable the City of Sebastian to determine the correct rate, and in accordance with cemetery rate regulations, residence of purchaser or person for whom lot is intended for interment must be provided at time of purchase Address Area Code & Phone Number Residence Address of Intended Occupant if Other Than Purchaser O�ce Use Only Don�,G.,+ ��. .,..I....,..d..,.�,.,.,.r ..., a�,... ......... _r. Ilars ($� ) on this / day of!i��_, 2Q��for the purchase of the following described Cemetery Lot(s) and/or Niche(s). /� .e�,c�E Unit�_, Blocl�-d_�_,��)�r/��7�?s IdiZfie(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 Signature of Purchaser of Sebastian W O H Circle One . Disinterment TO�L $ /, ,�9� 7"� Service fees are to be paid at time of need only I:\VWV-DATA\Ms-CemeterylRECEI PT.doc � KENNETH E DOUGLAS ALICE F QOU�LAS PO BOX 781394 SEBASTIAN, FL 32978 . ,, � ��x�� 680 sa-� y �ais�o _ , � �� ' -Z._— � _ �, .-� Daee �� I �:0670 L L i4 2�:_ L000 L 3086 LO��' 0680 7 N � S /�� m 1 O w O m • ! � f � m � • . � � x 1 0 a d � � e� d m a � � ` � E� 0 0 0 o g o o; o ° o 0 0 0 0' 0 w G�.1 A � � N OOo Oo OD (O tD �G tD ., O � O O O O O � . r m o �-�.. � O o e� n+ fD Z' � � � � � �G y m � �, � �. � � � � � X T r C O N N � � n � y � j • m � � � � c ' ` O � ❑ ❑ � � � d m „ � � � D � 0 c � � v 0 d a . nm n A n � m R1 T � y f%f m � O y T � T S C7 Z m w -� � �O