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HomeMy WebLinkAbout3-COL-41DsACertificate No. 2187 CITY OF SEBSTIANI Certificate of Interment Rights IN ACCORDANCE with provisions of the Code of Ordinances of the City of Sebastian, it is hereby certified that: James & /or Lindsey Fucci 1640 Addle Street, 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 niche: Unit 3, COL, Niche 41DSA 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 July, 2008. CITY PF SEBAS7IAN, FLORIDA O CAI Minner ,City- Manager ATTEST: t_ Sally &.�'Maio, MMC City Clerk Name t1,1 WIS Unit -1 Block e OA Lot ,C Y1 Date of Mark -out ,•- Date of Burial '/r-7 t Time a Name of Funeral Home Authorized by N Vero Beach Crematory 916 17"' Street Vero Beach, Florida 32960 772 -562 -2325 Cremated Remains Dennis Scott Bailer Vero Beach Crematory 916 17th Street Vero Beach, Florida 32960 We hereby certify that these are the cremated remains of.- Dennis Scott Bailer Sebastian Florida (City) (State) 1228 -08 -0320 Strunk Funeral Home & Crematory (Permit Number) (Funeral Home In Cherge) June 28, 2008 July 3, 2008 (Date of Death) (Date of Cremation) ey: p Cremator Signature 01154 Cremation /D Number Obituaries I Death Notices I Newspaper Obituaries I Online Obituaries I Newspaper D... Page 1 of 1 DENNIS "DENNY" BAILER Dennis "Denny" Bailer, 53, died June 28, 2008, at Indian River Medical Center in Vero Beach. He was born in Cincinnati and moved to Sebastian 38 years ago, coming from his birthplace. He attended ARC workshops and was a gold medalist in the Special Olympics, where he competed for many years. Survivors include his brothers, Bruce Bailer of Sebastian and Frank Hotze of Cincinnati. Memorial contributions may be made to ARC of Indian River County, 1375 16th Avenue, Vero Beach, FL 32960. SERVICES: Services will be at a later date. Arrangements are by Strunk Funeral Home, Sebastian. Published in the TC Palm on 7/2/2008. Today's TC Palm obituaries and death notices Questions about obituaries and death notices or Guest Books? Contact Legacy.com • Terms of use Powered try L.egacy.Gom obituaries nationwide Back http: / /www.legacy. com/tcpalm/Obituaries. asp ?Page= LifeStoryPrint &PersonID= 112623 ... 7/9/2008 afftf S F0 L 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, proof of City residency of purchaser or person for whom lot is intended for interment must be provided at time of purchase. Name(s) ne's �, L I, yld_5 e-,u -ruui S+ . SCba5-hran 32- Address 3R& -� Area Code & Phone Number Sep i s Yl i e m o� betin 16 Name & Residence Address of Intended Occupant if Other Than Purchaser Receipt is acknowledged in the sum of: OFFICE USE ONLY lars ( on this D -�k day of l� (u , 2009 for the purchase of the following described Cemetery Lot(s) and /or Niche(s). Unit , Block L I , Lot(s) Niche(s) 4 ( JS fi 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 150,()o / W O H Circle One Vase and Ring for Niches (cost) Temporary Marker Preparation & Installation Signature of Purchaser Interment qo - 0o Disinterment TOTAL $ Z/ gO,DD qj- 0jjL,r�n4- of Sebastian The following documents were provided as Proof of Residency: L \WW- DATA \Ms- Cemetery\RECEIPT.doc I and CITY OF SEBASTIAN CITY CLERK'S OFFICE 4089 RECEIPT Name � Kbt In � ❑ Cash Date Check # 7q� No. Amount Paid 001001 208001 Sales Tax 001501 322900 Garage Sales 001501341920 Copies/Bid Specs. 001501341910 LDC /Code of Ordinances 001501 341930 Election Qualifying Fees 601010 343800 Cemetery Lots Del) (),is i,' i ex �jy�� �'""`-^' ©p Lot/Niche M, Block VtJ1_, Unit 001501 343805 Cemetery Fees A, wf� Total Paid c�CA`1 Initials White - Dept. of Origin • Yellow - Finance • Pink - Applicant FUNERAL DIRECTOR'S REQUEST TO CITY OF SEBASTIAN FOR BURIAL OPENING IN SEBASTIAN MUNICIPAL CEMETERY me r HOME OF PELICAN ISLAND For information contact: Kip Kelso - Cemetery Sexton Sebastian Municipal Cemetery (772) 589 -2545 City Clerk's Office City Hall, 1225 Main Street Sebastian, FL 32958 Office (772) 388 -8215 or 388 -8214 Fax: (772) 589 -5570 FUNERAL HOME: Strunk Funeral Home ADDRESS: 1623 N. Central Avenue, Sebastian, FL 32958 PHONE #: 772- 589 -1000 " (Check One) OPEN BURIAL LOT Lot Block Unit OPEN CREMAINS LOT Lot Block Unit x_OPEN COLUMBARIUM NICHE NicheRDSA Block Col Unit 3 BURIAL DATE AND SERVICE TIME: July 25, 2002 P-. E W Gf: FOR DECEASED: Dennis Scott Bailer Name NAME AND SIGNATURE OF LOT OWNER OR REPRESENTATIVE: (Must provide proper documentation of ownership) bn(ta I F(to P/ ,,h A I /, 1 -41 17- 0 Name i nature U Date I certify that I have determined the ownership of the above described site, that all site fees and administrative fees have been paid and authorize opening of same. NAME AND SIGNATURE OF LICENSED FUNERAb DIREOTOR: Name re . PP Date Cemetery Sexton Certification: 1 certify that I have checked the ownership information by viewing the owner's deed and confirming with Clerk's office and that all fees have been paid: Cemet6ry ext n Date This form to be provided to Clerk's Office by Sexton for permanent record upon completion. 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