HomeMy WebLinkAbout3-COL-14DsCffYOF
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HOME OF PELICAN ISLAND
Certificate No. 2172
~~ ~~ ~ ~~
Certificate of Interment Rights
IN ACCORDANCE with provisions of the Code of Ordinances of the City of
Sebastian, it is hereby certified that:
Pedro 8~ Rocio Quevedo 733 Wimbrow Drive, Sebastian, FL 32958
(name) (address)
In and for consideration of the sum of $2,400.00 is entitled to full interment
rights in the Sebastian Municipal Cemetery for the following niche:
Unit_3_Col_Niche_14Ss_
of the Sebastian Municipal Cemetery,
as maintained on file in the records of the City Clerk
for use in accordance with the conditions, ordinances, resolutions, rules and
regulations prescribed therefore by the City of Sebastian.
CONVEYED THIS 28th day of March, 2008.
OF ;~~BASTIAN, FLORIDA
CAI Minner
City Manager
ATTEST:
i
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Sally Maio, MMC
City Clerk
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f ~~ l' i,~111 i l./ S
Name /",~ ~ ~~ ~ ~ ~? _< ~ ~
2
Unit
Block ~ '~
Date of Mark-out
Date of Burial a ~.~ T„~ ~`~' ~ Time /l' ~ ~ 1¢
Name of Funeral Home ~ ] ~ ~, q ,,,'
f~ n'11.. ~1V1.X..~t~~(!~
Authorized by
CITY OF SEBASTWN
CtTlf CLERK'S OFFICE ~ 3 9 71
QQ , /~ /~ ,~ RECEIPT
Name ~ ~ G V C.~t.V ^ C~oh
Date . ~ ' Z ~ ' ~ d Check /;3~ ~y
No. Amount Paid
001001208001 Sales Tax
001501322900 Garage Sales
001501341920 CopieslBid Specs.
001501341910 LDC/Code of t>rdfnances
001501341930 Eke;tion Aualifying Fees
601010343800 Cemetery L~o/t~s, ~ ~,. ~1 ~ ~. ~
LotMk~e I -T JT Bkx~c w ~ . Unit ~_
001501343805 Cemetery Fees QlL' ~~~•~
~Q.S P. ~ Y'i na ~~,o~
Total Palo ~°5~,~
Initials
Whito - Dspt. of Orrin • ye0ow - Finonq • Pink • Appllcsnt
a~ ~
S~BAS~~V ~~
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HOME OF PELIUN ISLAND ~'
City of Sebastian Municipal Cemetery
Purchase Receipt
To enable the City of Sebastian to determine the correct rate, and in accordance with cemetery
rate regulations, residence of purchaser or person for whom lot is intended for interment must be
provided at time of purchase
1~~-~o aid ,~v c ~e o Q ~~ ~ ~d o
Name(s)
Address
~7 ~~ 1,..~~ q J o ~
Area Code & Phone Number
Residence Address of Intended Occupant if Other Than Purchaser
Office Use Only
Receipt is acknowledged in the sum of:
~~o-Dollars ($ ~~d. U0 )
on this day of , 20 for the purchase of the following
described Cemetery Lot(s) and/or Niche(s).
Unit ~_, Block ,~L ,Lot(s) Niche(s) j `-t~ 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 8 Closing
~J ee~da-~
W O H
Circle One
Vase and Ring for Niches (cost) ~ ~~~ ~~ Interme~ i ~ ~ ~ Disinterment
Signature of Purchaser
TOTAL $ c~,~0 ~oZ o DD C;I~L~C~~-
of Sebastian
Service fees are to be paid at time of need only
I:\W W-DATA\Ms-Cemetery\RECEIPT.doc