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SE
HOME OF PELICAN ISLAND
Certificate No. 2642
CITY OF SEBASTIAN
Certificate of Interment Rights
IN ACCORDANCE with provisions of the Code of Ordinances of the City of
Sebastian, it is hereby certified that:
Jim J. Harris
674 Dot Circle
Sebastian, FL 32958
In and for consideration of the sum of $1,200.00 is entitled to full interment
rights in the Sebastian Municipal Cemetery for the following niche:
Unit 3, Blk COL, Niche 40Sn
of the Sebastian Municipal Cemetery,
as maintained on file in the records of the City Clerk
for use in accordance with the conditions, ordinances, resolutions, rules and
regulations prescribed therefore by the City of Sebastian.
CONVEYED THIS 9th day of July 2019.
CITY OF SEBASTIAN, FLORIDA
'/
"Paul E. Carlisle
City Manager
ATTEST:
JarAette Williams, MMC Clerk
moo.
SEBASTL
HOME OF PELICAN ISLAND
1225 Main Street
Sebastian, FL 32958
(772) 589-5330 Phone
July 15, 2019
Mr. Jim Harris
674 Dot Circle
Sebastian, FL 32958
RE: Interment Rights to Unit 3, Block COL, Niche 40Sn, Sebastian Municipal
Cemetery.
Dear Mr. Harris:
Enclosed is City of Sebastian Certificate 2642 entitling you to full interment rights in
Unit 3, Block COL, Niche 40Sn in the name of Jim J. Harris.
If you have any questions, please contact our office at 388-8209.
Sincerely,
r
Cathy T2 a
Records Clerk
Enclosure
SE�TWN
HOME or PELKM Isom
MFIZ- To .
Po gcY -79041;.
SobsrlH-r') , FL.
City of Sebastian Municipal Cemetery Purchase Receipt
3�n7F
To enable the City of Sebastian to determine the correct rate, and in accordance with cemetery rate
regulations, proof of City residency of purchaser or person for whom lot is intended for interment must
be provided at time of purchase.
21;IA T t s
Name(s)
1�-74 bo r tKc le -P6,J
Address
-? -7a -3 " _S4-rz
Area Code & Phone Number
Name & Residence Address of Intended Occupant if Other Than Purchaser
OFFICE USE ONLY
Receipt is acknowledged in"the sum of:
T�zlve lr�Ir� }-i "A00— Dollars($ 1.-ZCC )
on this of "\ day of JU 1t -I. .20 (Rfor the purchase of the following described
Cemetery Lot(s) and/or Niche(s). IJ
Unit 3 , Block CO L- , Lot(s) Niche(s) 40 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:
Comer Markers (set of 4 - $20) Opening & Closinc
Vase and Ring for Niches (cost)
& Installation
be
/W O H
Circle One
Interment Disinterment
TOT
AL$ J� OD
City ofSebastia#/V
The following documents were provided as Proof of
'Residency:
I )0W1Z' Lt" -r- r and
CITY OF SEBASTIAN 11711
ADMINISTRATIVE SERVICES RECEIPT
Name S _ O Cash
Date I I I eI heck #
U Credit
Amount Paid
001001208001 Sales Tax
001001 220000 Security Deposit
001501 362100 Taxable Rent
001501 362150 Non -Taxable Rent
450010 369900 Airport Badge
001001218010 CobraServe
001501 354100 Code Enforcement Fines
001501 347557 Community Center Revenue
001501341920
Copies
001501 351140
Parking Citation
001501 342100
Police Security Services
001501 329200
Site Plan Review
001501 329300
Subdivision/Plat Review
001501 329100
6. 1rtc --7,
Zoning Fees
N1cAlc--- IRee eb
t.� 3 Btkect�l,r� �le�„ �v, t�
Total Pal� ]M
Initials
White - Dept. of Origin - Yellow -Admin. Svcs. - Pink - Applicant
QTY OF
E BA�A�s T� "�
HOME OF PELICAN ISLAND
Certificate No. 2188
CITY Off' SEB STIAN
Certificate of Interment Rights
IN ACCORDANCE with provisions of the Code of Ord es of the City of
Sebastian, it is hereby certified that:
Rose Masi 851 Dunn Terrace//Sebastian, FL 32958
(name) ( dress)
In and for consideration of the sum of $1A00.00 is entitled to full interment
rights in the Sebastian Municipal CemetXry for the following niche:
Unit 3, CO,L', Niche 40SN
of the Seba ian Municipal Cemetery,
as maintained on le in the records of the City Clerk
for use in accordance wit the conditions, ordinances, resolutions, rules and
regulations prescribed YAerefore by the City of Sebastian.
JCOJEYE THIS 2 " day of February, 2009.
BA IAN, FLORIDA ATTEST,
I Minner Sally Per. Maio, MMC
ty Manager City Clerk
N qost�
NuQu °3 sn„ �a+we ��aie�
Certificate No. 2188
CITY OF SEBASTIAN
Certificate of Interment Rights
IN ACCORDANCE with provisions of the Code of Ordinances of the City of
Sebastian, it is hereby certified that:
Rose Masi 851 Dunn Terrace, Sebastian, FL 32958
(name) (address)
In and for consideration of the sum of $1,200.00 is entitled to full interment
rights in the Sebastian Municipal Cemetery for the following niche:
Unit 3, COL, Niche 40SN
of the Sebastian Municipal Cemetery,
as maintained on file in the records of the City Clerk
for use in accordance with the conditions, ordinances, resolutions, rules and
regulations prescribed therefore by the City of Sebastian.
COP�VEYEQ THIS 20th day of February, 2009.
BASTIAN, FLORIDA
Al Minner
ty Manager
ATTE,S-T,:
Sally . Maio, MMC
City Clerk
MOF
X
Sioux
s:
HOME OF PELICAN ISLAND.
Certifica 0.2188'
r CITE OF SE$x�T
Certificate of Interme "` Rights
-P ' ANCE .w th rovisions af. C de of Ordinances of City �of
IN ACCQ p i tY
�Sebasti it i$rh6reby` certified that `
Rosy` "`Masi 85 `:Dunn �rr��ce, 5�bastian, FL 32958
(name) (address)
In "and for consideration of the um of $ , 0.OWis entitled to full interment
rights in the Sebastian Mun,Jc' al Cemetery for the:following niche:
U ' t 3, COL, ,Niche 40SNB
Of Sebastian kuniciloo, Cemetery,
as mainta' ed on file in the rec u of .the City Clerk
for use in accord-
ccord ce with the condition ordinances, resolutions, rues and
regulations pre ribed therefore by the 'tity of Seibastiallk
CONVEYED IS 10th day of July, 2008.
CI OF ASTIAN, FLORIDA ATTEST:
:y Clerk
Certificate No. 2188
Certificate of Interment Rights
IN ACCORDANCE with provisions of the Code of Ordinances of the City of
Sebastian, it is hereby certified that:
Rose Masi 851 Dunn Terrace, Sebastian, FL 32958
(name) (address)
I f2U01//W V
In and for consideration of the sum of . 0 is entitled to full interment
rights in the Sebastian Municipal Cemetery for the following niche: Q
W1, AkUkr
Unit 3, COL, Niche 40S Px +
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.
a
Name 1tt %1 }rCicl�i�Cf"t,� "�%?���a�S�
Unit
Block
Lot
Date of Mark -out
r
Date of Burial r Q 6 Time
Name of Funeral Hom L l�r
Authorized by �f
a or
st
HOME Of PEUCAN 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.
W
Name(s) Ij '
&5.1 .Dckm n I-erract, Se_baS f�Oln , FL 32-g5-S-
Address
3 &F -��f
Area Code & Phone Number
Yn0-ria Saar
Name & Residence Address bf-- Intended Occupant if Ofher Than Purchaser
Receipt is acknowledged in the sum of:
OFFICE USE ONLY
Yu: A Dollars ($ /cW o." )
on this. O day of I Lk , 20 69 for the purchase of the following described
Cemetery Lot(s) and /or Niche(s).
Unit -3 , Block L, Lot(s)
Niche(s) 40 S N z
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)
Temporary Marker Preparation & Installation
Signature of Purchaser
15D,00
Interment 40, W
/W O H
Circle One
Disinterment
TOTAL $ IMO, U
j4ali�_ CJj F
ity of Sebastian
The following documents were provided as Proof of
Residency:
I: \VIM/- DATAWIs- Cemetery\RECEIPT.doo I and
FUNERAL DIRECTOR'S REQUEST TO CITY OF SEBASTIAN
FOR BURIAL OPENING IN SEBASTIAN MUNICIPAL CEMETERY
OWN
"OmE CK 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: — eAW 1 41*
ADDRESS: 73 S F'16 rr.- 0j g
PHONE #: 190q_.1933
(Check One)
OPEN BURIAL LOT
OPEN CREMAINS LOT
,,--OPEN COLUMBARIUM NICHE
BURIAL DATE AND SERVICE TIME
Lot Block Unit
Lot Block Unit
NichedifASOIP Block Co t Unit �S
N S E W
FOR DECEASED: m NZI Ar .SL► A 9,6
Name
NAME AND SIGNATURE OF LOT OWNER OR REPRESENTATIVE:
(Must provide proper documentation of ownershi
goSr !�'I Asp !L>9- ?. 9• off'
Name Signature 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
FUNERAL CTOR:
-A •. � �a� 7-940r
Name Signature Date
Cemetery Sexton Certification:
I certify that I have checked the ownership information by viewing the owner's deed and confirming
with Clerk's office and hat all fees have been paid:
Ce to S xton Date
r
This form to be provided to Clerk's Office by Sexton for permanent record upon completion.
Obituaries I Death Notices I Newspaper Obituaries I Online Obituaries I Newspaper D... Page 1 of 1
MARIA J. SUAREZ
Maria J. Suarez, 95, died June 17, 2008, at Sebastian River Medical Center. She was born
in Cuba and lived in Sebastian for 13 years, coming from Miami. She retired from St.
Mary's Hospital in Hoboken, N.J. as a registered nurse. Survivors include her son, Frank
Deloshoyos of Vero Beach; daughter, Rose Masi of Sebastian; sister, Annita Suarez of
Havana; four grandchildren; and six great - grandchildren. SERVICES: Visitation will be
from 2 to 4 and 6 to 8 p.m. June 20 at Seawinds Funeral Home, Sebastian with a wake
service at 7 p.m. Arrangements are by Seawinds Funeral Home & Crematory, Sebastian.
A guest book may be signed at seawindsfh.com /obit.php.
Published in the TC Palm on 6/19/2008.
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SEAWINDS CREMATORY
Sebastian, Florida
735 Fleming Street • Sebastian, Florida 32958
www.seawindsfh.com
(772) 589 -1933
We hereby certify that these are the remains of
MARIA J. SUAREZ
The remains were received
from SEAWINDS FUNERAL HOME AND CREMATORY
Cremation Permit No. 08- 2617 -120 Issued at INDIAN RIVER COUNTY
Date of Death JUNE 17, 2008
Date of Cremation JUNE 21, 2008 _ By SAM COBURN
Cremator
`-"' � Total Paid 00
Initials
White - Dept. of Origin 9 Yellow - Finance a Pink - Applicant
CITY CLERK'S OFFICE
RECEIPT
/, i O
4 I
Name I l
t+
❑ Cash
Date y —v
)(Check # u V
No.
Amount Paid
001001208001
Sales Tax
001501 322900
Garage Sales
001501 341920
Copies/Bid Specs.
001501341910
LDC /Code of Ordinances
001501341930
Election Qualifying Fees
601010 343800
Cemetery Lots
;'W0,00
Lot/Niche 9 ��
, Block
, Unit
001501343805
Cemetery Fees
1g0.00
`-"' � Total Paid 00
Initials
White - Dept. of Origin 9 Yellow - Finance a Pink - Applicant
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