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HomeMy WebLinkAbout4-10-40C[iY OF ~~,~I '.-~_.. r HOME OF PELICAN ISLAND Certificate No. 2174 Certificate of Interment Rights IN ACCORDANCE with provisions of the Code of Ordinances of the City of Sebastian, it is hereby certified that: Karen Steinke Post Office Box 68, Roseland, FL 32957 (name) (address) In and for consideration of the sum of $2,000.00 is entitled to full interment rights in the Sebastian Municipal Cemetery for the following lot: Unit 4 Block 10 Lot 40 of the Sebastian Municipal Cemetery, as maintained on file in the records of the City Clerk for use in accordance with the conditions, ordinances, resolutions, rules and regulations prescribed therefore by the City of Sebastian. CONVEYED THIS 15t day of April, 2008. CITY OF,S~BASTIAN, FLORIDA A(I [~I~Sn~r Cit ' anager ATTEST: D ccu ~~ f ~r k j ~or Sally A. Maio, MMC City Clerk Name `TNT: ~ /v%~? _~ ~`, f Unit ~.~ Block `~-~ Lot ~~ ~ /~ /,, ~. Date of Mark-out ~ ~ Date of Burial f ~`.~ ~" ' ``"' ~`' Time ~ ~~ ~~ ~(' /!1r Name of Funeral Home ..~ ~~ %"` ` ~ ' °"` ~ ' ~ ~'~' ~'~ . ~ ~ `~ Authorized by - ~' ~ ~^!"""~~~` ~~~ ~` Sebastian, Florida 735 Fleming Street • Sebastian, Florida 32958 www.seawindsfh.com (772) 589-1933 We hereby certify that these are the remains of THELMA JEAN HOLT ,The remains were received ftom SEAWINDS FUNERAL HOME Cremation Permit No. 08-2617-218 Issued at INDIAN RIVER Date of Death NOVEMBER 17 , 2008 Date of Cremation NOVEMBER 20 , 2008 By SAM COBURN dau9'~~`-Stave k~ / l'~~~ lM ~ ~. +~ ~ I -f- u ~-F 8 is ~ ~oQ ' X50. p~ sq«y Cremator ~tt OF S~B~T~N ~. _ _ ~ Y HOME OF PE4ICAN ISLAND City of Sebastian Municipal Cemetery Purchase Receipt To enable the City of Sebastian to determine the correct rate, and in accordance with cemetery rate regulations, residence of purchaser or person for whom lot is intended for interment must be provided at time of purchase C~a,~~~ ~ f~i n ~~. Name(sl Address Area Code & Phone Number Residence Address of Intended Occupant if Other Than Purchaser Office Use Only Receipt is acknowledged in the sum of: !~ ~3Z~5 7 ` Dollars ($ ~-~~~. ~ on this ~ ~ ~ day of r ~ ( , 20 U ~ for the purchase of the following described Cemetery Lot(s) and/or Niche(s). Unit ~ ,Block / 1) ,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 Vase and Ring for Niches (cost) Signature of Purchaser W O H Circle One Interment Disinterment TOTAL $ ~ D C)O . ~ O C' of Sebastian Service fees are to be paid at time of need only I:\W W-DATA\Ms-Cemetery\RECEIPT.doc STATEMENT 123382 Date o / /' ~ t9"_~ ~--' ,/~"'/,? M , ~ ` TERMS ~ ,~! `~' tN ACCOUNT 1NITH ~~ /S - /U ~~~ ~-- L.' / ~~/ 7 d_ S 1 ~ I r ~. 0 ~: • t f T 7 r ~ ~ To ~ ~ ~ Y 7 0 o g g S ~ _g = 0 o ° 0 ~ ~ ~ o g (~,~ ~~ W W (~,~ NN O ppOppA G~ O j O A O A O O ~ ~ ~ m m p ~ d d ~ c~~ ~ m .~ ~ ~3 ~ ~y ~' ~ ~ d ~ ~ ~' "~. O c d S z A n mmT mom ~~aa T ~ "s ~_ m ~, ^ ~ n ~ ? D 1. C 7 .9 L d W M~ W CITY OF SEBASTIAN CITY CLERK'S OFFICE RECEIPT n ~ ~~ Name ~ 1 j~, ^ Cash / D t / ~ - ~~11 / ~~ J V3 ~ ,~ ~ /~ Check #~ a e No. Amount Paid 001001208001 Sales Tax 001501 322900 Garage Sales 001501341920 CopiesBid Specs. 001501 341910 LDCICode of Ordinances 001501341930 Election Qualifying Fees ~ 0 ( T 601010 343800 Cemetery Lots LoUNiche ~, Block l ~/ , Unit ~_ ~ ©~ 001501 343805 Cemetery Fees (i~L • ~,~ k~' C~, 00 ' Total Paid ~ ~~ Initials White -Dept. of Origin • Yellow -Finance • Pink -Applicant