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HomeMy WebLinkAbout4-11-02C(iY OF ~~ ~~~~~~ HOME OF PELICAN ISLAND Certificate No. 2186 Certificate of Interment Rights IN ACCORDANCE with provisions of the Code of Ordinances of the City of Sebastian, it is hereby certified that: Mr. Frank DeJoia 11625 Roseland Rd, Sebastian, FL 32958 (name) (address) In and for consideration of the sum of $2,000.00 is entitled to full interment rights in the Sebastian Municipal Cemetery for the following lots: Unit 4 Block 11 Lots 1 & 2 of the Sebastian Municipal Cemetery, as maintained on file in the records of the City Clerk for use in accordance with the conditions, ordinances, resolutions, rules and regulations prescribed therefore by the City of Sebastian. CONVEYED THIS 2nd day of July, 2008. CI OF BASTIAN, FLORIDA ATTEST: ~; i 1(/ ~ ~ / AI Minner _ Sall .Maio, MMC ity Manager City Clerk __ ~.~ [~ _.__ ~ ~~ HOME QF P ELIC,AP3 ISL1iN~ City of Sebastian Municipal Cemetery Purchase Receipt To enable the City of Sebastian to determine the correct rate, and in accordance with cemetery rate regulations, proof of City residency of purchaser or person for whom lot is intended for interment must be provided at time of purchase. ((``~~~ X12 L~N~ ~~~ Name(s) Address I i j „ ~ ~~~ ' ~~~~/vl ~ ~-- ~~15 `7 Area Code & Phone Num Name & Residence Address of Intended Occupant if Other Than Purchaser OFFICE USE ONLY Receipt is acknowledged in the sum of: ~1~fl ~~Q~~ -Dollars ($ 0~-000 -°~ ) ~~11 N~ on this. o~ day of , 20~ for the purchase of the following described Cemetery Lot(s) and/or Nich ). Unit ~ ,Block ~, Lot(s) ~ ~i o2 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 O H ircle One Vase and Ring for Niches (cost) Interment Temporary Marker Preparation & Installation Disinterment TOTAL $c~.-~~ ~ Signature of Purchaser The following documents were provided as Proof of Residency: !:\wW-DATA\Ms-CemeterylREGEIPT.doc ' and City of Sebastian Name ~~ Unit Block ~ Lot Date of Mark-out ~' / -~ ~ / ° Date of burial ~ °~ e ~ Time ..~° / Name of Funeral Home `~ u ~'~ ~ (~ Authorized by ~" ~" `~" '~ ~"' N W .C' W Name ~ s Unit ! Block, Lot Date of Mark-out G ~ 3 a ~~ 8 Date of Burial l / ~ /O S Time ~l ~ 00 /¢. < ~ yf SS , ,~ ~_ Name of Funeral Homy 5 ~Kuk +~ Authorized by Obituaries ~ Death Notices ~ Newspaper Obituaries ~ Online Obituaries ~ Newspaper D... Page 1 of 1 JOYCE DEJOIA Joyce De]oia, 81, died June 28, 2008, at VNA Hospice House in Vero Beach. She was born in Bowling Green, and lived in Roseland for 28 years, coming from Boca Raton. She received her bachelor's degree in education from Florida State University. She taught in Tallahassee, San Juan, Puerto Rico, Tokyo, Japan, and Venezuela. Survivors include her husband of 52 years, Frank DeJoia; sons, Thomas DeJoia of Boca Raton, and Stephen DeJoia of Sebastian; daughters, Mary Ramsay of Virginia Beach, Va., and Diana Ferry of Montrose, N.Y.; brother, Archie Harris Jr., of Lake City; sisters, Martha Spence of Nevarre, Mary Heintz of Montecello, and Carol Miller of Deland; and seven grandchildren. She was preceded in death by her brother, Peter Harris. Memorial contributions may be made to the Friends of St. Sebastian River, P.O. Box 284, Roseland, FL 32957. SERVICES: Visitation will be from 5 to 7 p.m., July 1 at the Strunk Funeral Home, Sebastian. A Mass of Christian Burial will be celebrated 11 a.m., July 2 at St. Sebastian Catholic Church, Sebastian. Burial will follow at Sebastian Cemetery. Arrangements are by Strunk Funeral Home and Crematory, Sebastian. Published in the TC Palm on 7/1/2008. Today's TC Palm obituaries and death notices Questions about obituaries and death notices or Guest Books? Contact Legacy.com • Terms of use Pai~r~red b~ LC~;t1t~'.GOCII obituaries nationwide Back U ~~ ,~( 3Zg57 ~~~ -~9~~ http://www.legacy.com/tcpalm/Obituaries.asp?Page=LifeStoryPrint&PersonID=112575... 7/8/2008 A. FLORIDA DEPARTMENT OF HEALT (TYPE} State of Florida, Department of Health, Vital Statistics APPLICATION FOR BURIAL -TRANSIT PERMIT 1. Name of First Middle Last Date Month Day Year Deceased Joyce DeJoia Death June 28 2Q~08 2. Place of Death City, Town or Location Name of (If neither, give street address) County Hosp. or Indian RiYt?C Vero Beach Inst. ~lN~e HOSI31Ce House 3. Name of Medical Address Phone Number Certifier Richard Penly, .D. 901 37th Street Medical Examiner Physician Vero Beach, FL 772-978-5600 4. Name of Funeral Home/Giraet-Bifies~l Address Fla. Lic. No./Reg. No. Phone No. (Area Code) Establishment 1623 N. Central i~lYe. trunl< Funeral i•lome ~ Greimat0 y Sebastian, FL 3228 772-589-1000 a. ~necx a. LJ t ne medical certmcanon has been completes and signed. A completed certificate of death accompanies this Appropriate application. Box b. ~ Sonya was contacted on 6 /28 /08 He/she verified that this death was from natural causes, that there was no accident nor other external cause of death, and that Dr. Penly will complete and sign the medical certification of cause of death within 72 hours. c. ~ was contacted on Helshe verified that Medical Examiner, will complete and sign the medical certification of cause of death within 72 hours. 6. Funeral Director/ Signature F.E. No./Reg. No. Date Signed DiFeetBisposeT 22789 6 / 30 /08 B. BURIAL -TRANSIT PERMIT Permission is hereby granted to dispose of this body. Permit No. 1228-08-0318 A five (5) day extension of time for filing the death certificate (exclusive of weekends) has been requested and granted since the physician has been contacted by the funeral director and will not be able to complete the medical certification of cause-of-death section of the death certificate within 72 hours. ~No extension of time for filing the death certificate has been requested. F~eejl5tT~1'>SF ~ Date Date Certificate Subregistrar Signature ~, Issued: ~ /2$ /08 Due: 7 /2 /0$ v - - -- c. AUTHORIZATION for CREMATION, DISSECTION, or BURIAL-ATSEA Approval Number: Date Medical Examiner, ,gave authorization by telephone to Funeral Director/Direct Disposer. Date The Medical Examiner's approval must be obtained before disposal by any of the above methods. Awaiting period of 48 hours after death is required for all cremations. D. CEMETERY OR CREMATORY Method of Disposition: Place of Disposition SeljaStt~f-t Ce~t;i!-, ; x• ~,; BURIAL STORAGE Date of Disposition ~~2 ~p S CREMATION OTHER (Specify) Signature of Sexton or Person-in-Charge This permit must be endorsed by the Sexton or person-in-charge (or by the Funeral Director/Direct Disposer when there is no Sexton) and returned within 90 days to the local County Health Department in.the county where disposition occurred. Distribution: White: Cemetery or Crematory DH 326, 8/97 (Obsoletes all previous eddans) Yellow: Funeral Director or Direct Disposer (Stock Number X740-060-0326-2) Pink: Local Registrar ~~ i~ ,~