The URL can be used to link to this page

Home My WebLink About4-24-26o G; MY OF SE$ALSTIAN HOME OF PELICAN ISLAND cop � Certificate No. 1984 CIT- ) Y" 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: Elizabeth Van Zile 1122 Royal Palm Dr., Barefoot Bay, Fl 32976 (name) (address) in and for consideration of the sum of $1,125.00 has purchased and is entitled to full interment rights in the Sebastian Municipal Cemetery for the following plot: Unit_ 4_ Block _24_ Lot _26_ 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 20th day of August, 2004. Y OF SEB IAN, FLORIDA ST: rren4anAagger R oore lly A. Maio, CMC City City Clerk ,O Name Unit Block Lot Date of Mark -out Q Z� () 0 Date of Burial Name of Funeral Authorized by` ` � 3 �T Time r I moved to Barefoot Bay seven months ago.tom Cypress, Texas. Ms. Van Zile Rivera was a technical support person at Cardinal Health, Houston, Texas; for. eight years, She was a member of the Italian American Club and-the Up- state New York Club, both of Barefoot Bay., .Survivors are her mother, Betsy Van Zile, of Barefoot :. Bay; sister Sandy.Hoffarth, of Penfield, N.Y.; and mater- PPM18 L. Yee .Zile nal grandparents Rose and Rivera, Andrew p'Hondt, of Barefoot Bay. $arWed Bay Memorial contributions . may be made to VNA Hos- Cynthia L. "Cindi" Van pice: of Indian River County, Zile Rivera, 48, of Barefoot , 1110 35th Lane, Vero Beach, Bay; died Aug. 19; 2004; at Se- ' FI 32960, bastian River:Medical Cen-: SERVICES: A funeral sere - ter, Roseland, after a brief ill- ice will be at 11 a.m. Satur- 13M day at Strunk Funeral Home, She was-born June 19,. Sebastian, with the Rev. Ron - 1956, in Rochester, N.Y.; and aid Thomas Sr. officiating. Name Unit Block Lot Date of Mark -out Q Z� () 0 Date of Burial Name of Funeral Authorized by` ` � 3 �T Time r I aiY Of SE$' HOME OF PELICAN ISLAND coup� 1225 Main Street, Sebastian, F132958 Telephone (772) 589 -5330 —Fax (772) 589 -5570 August 23, 2004 Elizabeth Van Zile 1122 Royal Palm Drive Barefoot Bay, Fl 32976 Dear Ms. Van Zile: Enclosed is City of Sebastian Certificate 1984 for the purchase of Cemetery Lot 26, Block 24, Unit 4. Also enclosed is a copy of your receipt and the Rules and Regulations governing the Sebastian Municipal Cemetery. If you have any questions, please contact our office. Si er ly, Sally A. aio, CMC City Clerk SAM:ar enclosure alyor HOME OF PELICAN `ISLAND City ®f Sebastian Municipal Cemetery Purchase Receipt -, 114 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) Address Area Code & Phone Number Residence Address of Intended Occupant if Other Than Purchaser Office Use Only Receipt is acknowledged in the sum of: on this '"o day of _L described Cemetery Lot(s) an lars ($l l ,zS'--d o ) 2Ln� I—/ for the purchase of the following Unit_, Block; Lot(s) 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) Signature of Purchaser Interment Z/:,-, of Sebastian Disinterment Service fees are to be paid at time of need only 1:1W W- DATAXMs- Cemetery\RECE1PT.doc W O H Circle One $/ /a1S',ao CRY OF SEBASTIAN CRY CLERK'S OFFICE 0 RECEIPT Cash Ix heck #- /` Amount Paid I Sales Tax Garage Sales Copies/Bid Specs. LDC/Code of Ordinances Election Qualifying Fees Cemetery Lots LotNkhe . Block Unit 1 Cemetery Fees /j—Wed i Us r Total Paid White - Dprt- of Origin • Yellow - Finance • Pink - Applicant VAN - ' dl.ti- k . s�G SST 0 A0 ®Seca r(t enh nrt C do a -m en t. bock or detn- ils..� STRUNKFUNERAL HOMES, P-A, CASH ADVANCE ACCOUNT - SEBASTIAN 916 7TH ST. 4707 VERO BEACHj,FL 32960 PH. T12- 562 -2325 q' l' O HE DATE , I 0 T 63- txows�o .ORDER OF SeA�CI 0/L�. OI. • O L L A R S 8 --- m 9 5840th Platy 1pm - �a,� Vro t5WSeh, w 34980 Indiae lu., Nati0oal Baalt wut agNe.eom • FOR A N ZA.L 11'00 4 70 7119 (;0.70 120 5 -71; - - - _ a' 0 20 6 12 5 20,1111 C" or SEISASTL NOME 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 ,Li2A,/o/ � 4/./1 G � /F Name(s) �/a71 �.�►/ i�.s�m c�.t2. �JL_ 04ec ro' '&9V Address Area Code & Phone Number Residence Address of Intended Occupant if Other Than Purchaser Office Use Only Receipt is acknowledged in the sum of: on this o day of , 2C1� for the purchase of the following m described Ceetery Lot(s) and/ Niche(s). Unit_, Block 5; Lots) 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 W O H Circle One Vase and Ring for Niches (cost) Interment Disinterment T AL $/ 4,2 -57a o Signature of Purchaser tity of Sebastian Service fees are to be paid at time of need only I: \W W- DATA \Ms- Cemetery\RECE I PT.doc ELIZABETH VAN ZILE 1122 ROYAL PALM OR BAREFOOT BAY, FL 32976 11 -91 CITY OF SEBASTIAN CITY CLEWS S OFFICE 3087_ Name �`— ❑ Cash Date d eckifl� % % No. Amount Paid 001001208001 Sales Tax 001501322900 Garage Sales 001501341920 Coples/Bkl Space. 001501341910 LDC /Code of Ordinances 001501341930 Election Qualifying Fees 601010 343800 Cemetery Lots 17 Ao( LotMichgog / . Block on 7 Unii�Y 001501343805 Cemetery Fees Total Paid l ADD in, White - Dept. of Origin • Yellow - Finance • Pink • Applicant ••�� -� 3277 Date 63- 27/631 R 677 (� C--'j rry Dollars B � BankofAmenca. ACH RR 063100277. For N per► a* 1:0631002771 0022LoS553339ue 32`77 EPARTMENT OF FLORIDA ifi i A rTVPPN State of Florida, Department of Health, Vital Statistics APPLICATION FOR BURIAL - TRANSIT PERMIT on 1. Name of First Middle Last Date Mont Da Year Deceased Cynthia L. Van Zile- Rivera of Death Aug. 19 2004 2. Place of Death City, Town or Location Name of (if neither, give street address) County Hosp. or 1 ndina River Roseland Inst. Sebastian River Medical Center 3. Name of Medical Address Phone Number Certifier Noor Merchant, M D. 13060 U.S. #1 Medical Examiner I Physician Sebastian, FL 772- 589 -0879 4. Name of Funeral Home /rumcf nigpncal Address Fla. Lic. No. /Reg. No. Phone No. (Area Code) Establishment 1623 N. Central Ave. Strunk Funeral Home Sebastian, Florida 1228 772- 589 -1000 5. Check a. The medical certification has been completed and signed. A completed certificate of death accompanies this Appropriate application. Box b. Melia was contacted on 8/19/04 He /she verified that this death was from natural causes, that there was no accident nor other external cause of death, and that Dr. Merchant will complete and sign the medical certification of cause of death within 72 hours. C. r was contacted on He /she verified that Medical Examiner, will complete and sign the r%ediqXVertifPa,WXSause of death within 72 hours. 3. Funeral Director/ S' u F.E. No. /Reg. No. Date Signed 1862 8/19/04 B. BURIAL - TRANSIT PERMIT D Permission is hereby granted to dispose of this body. Permit No. 1228-04-0331 ® 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. -* Date Date Certificate Subregistrar Signature - ( Issued: 8/19/04 Due: 8/24/04 -o Approval Number: AUTHORIZATION for CREMATION, DISSECTION, or BURIAL -AT -SEA 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. A waiting period of 48 hours after death is required for all cremations. Method of Disposition: BURIAL CREMATION Signature of Sexton 1 or Person -in- Charge Jr STORAGE OTHER (Specify) CEMETERY OR CREMATORY Place of Disposition Sebastian Cemetery Date of Disposition ?' Fhis 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 vithin 10 days to the local County Health Department in the county where disposition occurred. Distribution: white: Cemetery or Crematory tH 326, 8197 (Obsoletes all previous editions) Yellow: Funeral Director or Direct Disposer hock Number: 5740 -000- 0326 -2) Pink: Local Registrar