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HomeMy WebLinkAbout4-28-26i Name \v\11q YNE Ct P)9hscb Unit Block Lot I-NIMP Date of Mark-out—P -Date of Burial f �• � � � � Time 3STROwl< t�ulugqA� 0 r6p, Name of Funeral Home- Authorized...bY is WAYNE CHARLES;PAASCIi Wayne Charles_ Paasch, -53, of San Rafael, CA, died December 239 2004 at his residence after aprolonged -illness. He wasborn'July 26, 1951 in Do ylestown,-Pennsylvania. Wayne ` was a Computer Specialist an'd worked -for various companies for 30 years. ,:He was -a graduate of Archbishop Curl- ey High School in Miami, FL, and graduated with an MA.A. de- gree in. Business from the University of Florida; Gainesville, FL. He moved to California where he worked and was'a Vice -Presi- dent' of Bank of. America, San Francisco, CA. He left there, to go to work for Charles Schwab, as. Director of Internal Auditing. He will.be missed by his children, Christopher Wayne Paasch and. Stefanie Nichole Paasch, his parents, Ruth and Robert Paasch of Sebastian, FL and the mother of; his. two children, ..Vanda, Paasch; his aunts;* uncles; and. cousins, to' whom he was very dose. The family * will receive .friends from 1-3pm., December ' 31, 2004 at the. Strunk Funeral Home Sebastian, FL. A, funeral service will -follow at3pm in the funeral..home chapel. Interment will follow at. Sebastian Cemetery, Sebasti:an,:FL. 1Wayne . was a- very. loving'And 'beautiful son and father he., will 'be ,missed:byzil. paid obituary ~~ ~~$~T~N =~'. HOME OF PELIGN ISWVD Certificate No. 1997 C~~ Q)~~ ~~~~~~~~~~~~ Certificate of Interment Rights CONVEYED THIS 30th day of December. 2004. IN ACCORDANCE with provisions of the Code of Ordinances of the City of Sebastian, it is hereby certified that: Ruth A. Paasch 219 Cedar Street, Sebastian, Fl 32958 (name) (address) in and for consideration of the sum of $700.00 has purchased and is entitled to full interment rights in the Sebastian Municipal Cemetery for the following plot: Unit 4 Block 28 Lot 26 of the Sebastian Municipal Cemetery, as maintained on file in the records of the City Clerk for use in accordance with the conditions, ordinances, resolutions, rules and regulations prescribed therefore by the City of Sebastian. City Manager '° City Clerk CI11C OF .. .. r....,v;,a,~.. ti :sir: h' HONE OF FELiChN 15LAND 1225 Main Street, Sebastian, Fl 32958 Telephone (772) 589-5330 -Fax (772) 589-5570 December 30, 2004 Mrs. Ruth A. Paasch 219 Cedar Street Sebastian, Fl 32958 Dear Mrs. Paasch: Enclosed is City of Sebastian Certificate 1997 for the purchase of Cemetery Lot 26, Block 28, Unit 4. Also enclosed is a copy of your receipt and the Rules and Regulations governing the Sebastian Municipal Cemetery. If you have any questions, please contact our office. Sincerely, ,/ /. ~.. ~z~ 7 `~--__ . Sally A. 'o, MMC City Clerk SAM:ar enclosure QIY Of ~~~ J HOME OF PELICAN ISLAND City of Sebastian Municipal Cemetery Purchase Receipt To enable the City of Sebastian to determine the correct rate, and in accordance with cemetery rate regulations, residence of purchaser or person for whom lot is intended for interment must be p~i~d at time of purchase Name(s) ~ i 4 / : ~-~a~ ~~,c,~ 7` ~E,~,~s 7Lr~.,~ ~L . ~a2~'S cam,'' Address Area Code & Phone Number Residence Address of Intended Occupant if Other Than Purchaser Office Use Only Receipt 's acknowledged in the sum of: Dollars ($ Dd . 00 ) ~~--- - - on this s~~~ day of , 20~ for the purchase of the following described Cemetery Lot(s) and/or Niche(s). Unit , Block ~, Lot(s) o?~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 Signature of Purchaser ity of Sebastian W O H Circle One Disinterment ;QTAL~~ ~• ~ _ Service fees are to be paid at time of need only I:\W W-DATA\Ms-CemeterylRECEIPT.doc ~Cf1Y OF ~~~~ ~~'"~ti ~'~-~;.: .N ~r~ HOME OF PELIChN ISU4ND 1225 Main Street, Sebastian, F132958 Telephone (772) 589-5330 -Fax (772) 589-5570 December 30, 2004 Mrs. Ruth A. Paasch 219 Cedar Street Sebastian, Fl 32958 Dear Mrs. Paasch: Enclosed is City of Sebastian Certificate 1997 for the purchase of Cemetery Lot 26, Block 28, 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 ~ ~ S $ S p ° aZi o ° ~' o 0 0 $ i° o (~ o w .P A A A_ A N O c~T. ' g $ ~ o N $ $ m cn o 0 0 c M i S , . O ~ ~ c m m v o ~ oyi n co ~ m ~ co -i ~ ~ ~ g ~ ~ m K o ~ ~ LT ~ ~ y m ~ n ~ ~ ~ <~ ~ T ~ m~ m m ~ mym ~ ~ ~ p ~ T `A ~ r '{~}YT s ~ m= 0 • ~ ~ C ~ a ~ ~ ~ r v ~, ~ 3 ~ N 0 ,4 ~ ~ W o I ~ C ~ ~ ~~ n A ,, ,~ ~ , '~ RUTH A. PAASCH 993 561-589-8267 63-4/630 Fl 219 CEDAR ST. ,~/ 1064 \ SEBASTIAN, FL 32958 Date ~~~=,~~~ ~7` to'the order ~Q '`~' ~...~ ~""" £~''~~->~-TrrrSA(~~ ,~, Dollars BankofAmerica~' ACH RR 08700277 ~'' ~ ~ e Memo ~n"~1~'/ ~-F~~%t •'Y;'~Y'J'~C+' --,~~}='~~!!~.'v--~---+•~ __ _ "'- Z ~ ~ 1 ;^ ~ ~ J ~~ _.• ~ ~ ,~ ~'~ ~f,,)e P ~- ~~ a ~ ~ t ~ ~ ~ w , m ~ ~ v A O m s i T r m 3 0 ~ ~ 9 ~ Cl W Y w ~\, ~,,, ~- a s s s s s o d ~ ~ o ~ s W 0 0 0 0 $ ® A o ~ m v o obi m N /\ ~ ~"~ ~ tD -1 4 V ?i ~ r O ~ ~ N x ~... ~ ~ .~' °a m ~ N m c ~ n IIIII~~ IIII eRi °~° ~ 'S 0 d a n !'7 ~~ mmT y m -~ O ~ T ~ ~s mZ N C7 ~~~~. ~.~ APPLICATION AND PERMIT FOR DISPOSITION OF HUMAN REMAINS USE BLACK INK ONLY -MAKE NO ERASURES, WHITEOUTS OR OTHER ALTERATIONS ~1/ 1A. NAME OF DECEDENT--FIRST (GIVEN) 18. MIDDLE ~ 1C. LAST (FAMILY) 2. DATE OF BIRTH 3. DATE OF DEATH 4. Wayne i Charles Paasch MONTH, DAY, YEAR 07 26 1951 MONTH, DAY, YEAR 12 23 2004 M SA. CITY OF DEATH ; 58. COUNTY OF DEATH -OUTSIDE CALIF., 6. NAME, RELATIONSHIP, FULL MAILING ADDRESS AND ZIP CODE ENTER STATE OF INFORMANT Mill Valley Marin Ruth A. Paasch -Mother 7A. TYPED NAME AND ADDRESS OF CALIFORNIA -FUNERAL DIRECTOR OR PERSON ACTING AS SUCH ; ~B. CALIF. LICENSE NUMBER 219 Cedar S t Russell & Gooch Funeral Chapel =IFAPPLICABLE . Sebastian FL 32958 Mill Valle CA 94941 FD 633 270 Miller Ave , . , y, 8A. '¢XlIG\NATUREOFAPPLICANT-Persontakingpennrt;BB. DATE SIGNED /~ ACKNOWLEDGEMENT OF APPUCAN7 odzed dy Sectlon 103055 ~ n l 3af ery t t ~z tl p guan ~ o - ' \ ~ 12 / 2 3 / 2004 0l th H altth and ealdr and Sa Code ery Code antl wa s auNOn e urs to SecGan 7100 of / PERMIT THIS PERMIT IS ISSUED IN ACCORDANCE WITH PROVISIONS OF 9A. AMOUNT OF FEE PAID ; 9B. DATE PERMIT ISSUED ; 9C. SIGNATURE OF LOCAL REGISTRAR ISSUING PERMIT AUTHORIZATION OF THE CALIFORNIA HEALTH AND SAFETY CODE AND IS THE AUTHOR- P S I jgr r `n 1_ ~ ~ ~ J L ~ ~ t 1 ~~ ~ , ~ TE: TNI PERM T G E NO RIGHT OFD 5 OSAL OUTSIOE OF CALIFORNIA 13 . OO " -+ ~ ' ~w ~ - LOCAL REGISTRAR - ' 9D. ADDRESS OF REGISTRAR OF DISTRICT OF DEATH - ; 9E. ADDRESS OF REGISTRAR OF DISTRICT OF DISPOSITION - ANV CHANGE IN DISPOSI- IF DEATH OCCURRED IN CALIFORNIA IF DISPOSITION IS TO OCCUR IN ANOTHER DISTRICT IN CALIFORNIA TION REOUIRESANEW `ZO N. San Pedro Rd. , Ste. 2006, PERMIT TO SHOW FINAL DISPOSITION San Rafael, CA 94903 10. AUTHORIZED DISPOSITION(S) CHECK APPLICABLE ITEMS FOR CORONOR'S USE ONLY A. BURIAL (INCLUDES EN70MSMENT) ~ E. TEMPORARY ENVAULTMENT NDING -REMAINS LOCATED AT ^ I~ D I O l O B. CREMATION ~ F DISINTERMENT ( N ame an d A ddress ^ C. DISPOSITION OF CREMATED REMAINS OTHER ~ G SHIP IN TO CALIFORNIA . THAN IN A CEMETERY D. SCIENTIFIC USE ©D. TRANSIT TO OUTSIDE OF CALIFORNIA 11 A. NAME AND ADDRESS OF CALIFORNIA CEMETERY ;118. DATE BURT D 11 C. SIGNATURE OF PERSON IN CHARGE OF BURIAL BURIAL - y 12A. NAME AND ADDRESS OF CALIFORNIA CREMATORY 1128. DATE CREMATED 12C. SIGNATURE OF PERSON IN CHARGE OF CREMATION g ~ CREMATION m - 13A. NAME AND ADDRESS OF CALIFORNIA FACILITY RECEIVING REMAINS ~13B. DATE RECEIVED ~ 13C. SIGNATURE OF PERSON IN CHARGE OF FACILITY a SCIENTIFIC USE a - F 14A. NAME AND ADDRESS IN RECEIVING STATE OR COUNTRY WHERE ;148. DATE SHIPPED 14C. ADDRESS AND SIGNATURE OF PERSON IN CHARGE REMAINS OR CREMATED REMAINS ARE TO BE SHIPPED OF PLACING WITH THE CARRIER O TRANSIT Strunk Funeral Home, 1623 N. Central Ave Sebastian, FL 32958 - 15A. ADDRESS, NEAREST POINT ON SHORELINE, OR OTHER DESCRIPTION ;15B. DATE OF 15C. SIGNATURE OF PERSON IN 15D. LICENSE NUMBER OF SCAT7ERING/BURIAL SUFFICIENT TO IDENTIFY FINAL PLACE AND CA DISTRICT OF DISPOSITION.; DISPOSITION CHARGE OF DISPOSITION ;CREMATED REMAINS Dls- ATSEA OR IF BURIAL AT SEA, ONLY ENTER LATITUDE AND LONGITUDE ~ POSER - IF APPLICABLE DISPOSITION OTHER THAN IN A CEMETERY ~^' ' 1 /'1/~ r~ ~ _ ~r ~f / .,/r /~„ ~._yj.1T~_~ ~ / - ~ J J ~ l ~ ~ , .C ~ f-. . ~~ ' .~ 1 P G~ r y G ~ COPY 1 OF THE PERMIT ACCOMPANIES THE REMAII~IS TO THE STATED PLACE OF DISPOSITION. THE PERSON IN~CF~ARUs~ OF DIS9C~SITION IS RESPONSIBLE FOR COMPLETING AND FORWARDING THE PERMIT WITHIN 10 DAYS OF DISPOSITION TO THE REGISTRAR OF THE DISTRICT IN WHICH DISPOSITION OCCURRED OR THE DISTRICT NEAREST THE POINT WHERE THE CREMATED REMAINS WERE SCATTERED AT SEA. THE LOCAL REGISTRAR MAY DESTROY ANY ORIGINAL OR DUPLICATE PERMIT AFTER ONE YEAR FROM ISSUE DATE. COPY 1 STATE OF CALIFORNIA, DEPARTMENT OF HEALTH SERVICES, OFFICE OF STATE REGISTRAR VS9 (REV. 3/03)