HomeMy WebLinkAbout4-27-37Name Ck4 "
Unit_
Block_
Lot
Date of Mark -out "', /-� I/ ' .5^'
Date of Burial �%J ! Time /I. Oli A a&e
Name of Funeral Home s�I�Gci/flD.S
Authorized by
C�,�'aldl,oe CDoney
Z123120 - 2123115
CITY OF SEBASTIAN -
CITY CLERK'S OFFICE 4995
, ('1 n
/! RECEIPT 4 7 7
Name :Q (. 0010 ri U ❑ Cash G
Date 2 -24) -15 SYCheck# 5
415
No. Amount Paid
001001208001 Sales Tax
001501 322900 Garage Sales
001501 341920 Copies/Bid Specs.
001501 341910 LDC/Code of Ordinances
001501 341930 Election Qualifying Fees
601010 343800 Cemetery Lots
Lot/Niche 7 Block 27
Unit
001501 343805 Cemetery Fees
n�C lSo.Do
���QJ�t/"r"� Total Paid ().oi�
Initials
White - Dept. of Origin • Yellow - Finance • Pink - Applicant
TIE SEBAST.tAN CEMETE'R Y
CTY OF SEBASTIAN, FLOpMA
on this(" 7ay of
following described Cem
conditions as stated herein:
Description of Property:
Cemetery Lot
Purchase Pr%ce:
Terms and` Condition of sale:
eLO,—
for the purchase of the
pon the terms and
0 c Unit
This contract shall be �b.ind.ing upon both parties, the seller and the
Purchaser, when approved by the owner of the property above described.
I, or we, agree to purchase the above described property on the terms
and conditions stated in the foregoing instrument:
The City of Sebastian agrees to e11 the above m�•ed property to
the above Named purchaser(s) on the to d cy� itions stated in the
above instrument. � /�� /
• \�---/�' ty l of-5e+�•a liar_
i mess
f rI 7V...4 --- --- . —. - -- __
FOR BURIAL OPENING IN SEBASTIAN MUNICIPAL, CEMETERY
Me
C
MQR$ W IfttCM[ tfWiO
For information contact:
lop Kelso - Cemetery Saxton
Sabeatlan Municipal Cbrnetery
(772) 588.2545
City ve/*,& ofwce
City 140, 1225 Main Street
Sebastian, FL 32958
OrRce (772) 388-8215 or 388.8214
Fax. (772) 588-5570
Ft1NElk-AL HOME: &e_4&.11,VZkS i✓EiP,q,L / 4/r1�
►i DR SS: 73S
'Seel'-o/e, A-Zewlx1d: z5'Co.6,�sri,��rJ
PHONE #:��'2• sesp-i
(Ch 'Vne) � y
EN BURIAL LOT Loi % @ lock Z� Unit
06N CREMAINS LOT Lot Block Unit
PEN COLUMBARIUM NICHE Niche�i8lock""'—Unit
r� W
BURIAL DATE AND SER7e,00ot1_,01,4<
ME: Z Z7 /s r�i 40
FOR DECEASED: eacN4W
Name
NAME AND SIGNATURE OF LOY OWNER OR REPRESENTATIVE:
(Must provide proper documentation of ownershi
Name onature Date
I certify that I have determined the ownership of the above described 41te that all site fees and
administrative fees have been paid and authorize opening of some
NAME ANIS SIGNATURE.OF .LICENSED F EC R.
tr/a . Lelwlwaa:.
tvarne at
.......................-- -.----------.
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 theta fees have been -paid w
i
Cemetery exto Date
This form to be provided to Clerk's Office by Sexton for permanent record upon completion.