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4-10-17
CITY OF R ~ n e ~~ i ~IM~~~~~ rte. HOME OF PELICAN ISLAND Certificate No. 2183 Certificate of Interment Rights IN ACCORDANCE with provisions of the Code of Ordinances of the City of Sebastian, it is hereby certified that: Laverne Raines 36 Treasure Circle, Sebastian, FL 32958 (name) (address) In and for consideration of the sum of $2,000.00 is entitled to full interment rights in the Sebastian Municipal Cemetery for the following lots: Unit 4 Block 10 Lots 17 & 18 of the Sebastian Municipal Cemetery, as maintained on file in the records of the City Clerk for use in accordance with the conditions, ordinances, resolutions, rules and regulations prescribed therefore by the City of Sebastian. CONVEYED THIS 10th day of June, 2008. CITY fJF S,~~3ASTIAN, FLORIDA AI Minner ty Manager ATTEST: - Sally A~ City tl -'j~ ~~ ~~ ~ ~ Maio, MMC Clerk clot ~ S~,BASTI~j ~~ HOME Of PELICAN ISLAND ~ ~~ City of Sebastian Municipal Cemetery Purchase Receipt To enable the City of Sebastian to determine the correct rate, and in accordance with cemetery rate regulations, residence of purchaser or person for whom lot is intended for interment must be provided at time of purchase Name(s) .~~~ ~"~-P.cz~~a ~~ Ci rc~~, 5e-~a~5frc~.h ~~ 3Z~5$ Address Area Code & Phone Nu ~" es r n es Residence Address of I ended Occupant if er Than Purchaser Office Use Only Receipt is acknowledged in the sum of: ~,1~ ~~1,6-(,L,Q,~y1/1,G~ Q.VCD~ ~~D~O Dollars ($ ~C~ C~ 0 J QU ) on this ~ ~~f~ day of ~(~h ~ ~ , 20~ for the purchase of the following described Cemetery Lot(s) and/or Niche(s). Unit ~ ,Block C 0 ,Lot(s) 17 `~' l ~ 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 W O H Circle One Disinterment TOTAL $ oZl JrD ~ Q (~ Signature of Purchaser W . ' y of Sebastian Service fees are to be paid at time of need only ~~"D . pU I:\W W-DATA\Ms-Cemetery\RECEI PT.doc CITY OF SEBASTIAN CITY C RECE' pOFFICE ~ [) ~ n Name / C~o~ n l ".. - ~ ^ Cash / Date (~J " / ~ 1 CO ' C~~ Check # ~ R~9 No. Amount Paid 001001 208001 Sales Tax 001501322900 Garage Sales 001501341920 CopieslBid Specs. 001501341910 LDC/Code of Ordinances 001501 341930 Elecfion Qualifying Fees /~/~ U 601010343800 Cemetery Lots ~ ~/ ~ o ~ ~ ~ ~ t , Block L UNi e ,Uni !l ~I© 001501 343805 Cemetery Fees ~/ . /~ ' Total Paid ~ ~ ~~ ~ ~ Initials White -Dept. of Origin • Yellow -Finance • Pink • Applicant