HomeMy WebLinkAbout4-23-26bUnit
Lot
Date of Mark -out
Date ofoonal
Name ofFuneral Home
Authorized by
'
Time
CITY OF
S~ N
~_.
.. ;.. ,., y ~.,^...~<.. ;.r
HOME OF PELICAN ISLAND
Certificate No. 2195
C~~~ ~~~ ~~~~~~~~
Certificate of Interment Rights
IN ACCORDANCE with provisions of the Code of Ordinances of the City of
Sebastian, it is hereby certified that:
Patricia A. Smith 570 Dolphin Circle, Barefoot Bay, FL 32976
(name) (address)
In and for consideration of the sum of $1,000.00 is entitled to full interment
rights in the Sebastian Municipal Cemetery for the following lot:
Unit 4, Block 23, Lot 26b
of the Sebastian Municipal Cemetery,
as maintained on file in the records of the City Clerk
for use in accordance with the conditions, ordinances, resolutions, rules and
regulations prescribed therefore by the City of Sebastian.
CONVEYED THIS 30t" day of September, 2008.
CITY~/,OF,/~EBASTIAN, FLORIDA
AI Minner
ty Manager
ATT ST : - ~ ~ . F
Sally A.. Maio, MMC
'City Clerk
CIA' of
- ~-~ ~~
HOME 4F PELFf.AN I5tANF?
City of Sebastian Municipal Cemetery Purchase Receipt
To enable the City of Sebastian to determine the correct rate, and in accordance with cemetery rate
regulations, proof of City residency of purchaser or person for whom lot is intended for interment must
be provided at time of purchase.
OFFICE USE ONLY
Names J 3Z~! 7~,
7C.~ Do I ~ I~ ~ n C t ~'c. l e, ~oc,r~f oo+ ~ac~_ FL
Address
Area Code & Phone Number
~hymQS ~rfi h ~5rv1 i ~-!~
Name & Residence Address of Intended Occupant if Other Than Purchaser
Receipt is acknowledged in the sum of:
('~i"~-~- ~..~~'L(~-~,(.-!h~-~'1G~ Ck,h1,4~ ~U~G- `~--~ Dollars ($ ~, oho. ~'C ~ )
on this. o`er day of , 20 L)~ for the purchase of the following described
Cemetery Lot(s) and/or Niche(s).
Unit _~, Block ~, Lot(s) c~(p 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)
Temporary Marker Preparation & Installation
Signature of Purchaser
TOTAL $ I, % ~7 (~. v(7
!ty of Sebastian
The following documents were provided as Proof of
Residency:
ISo.vo
/W O H
Circle One
Interment ~ • b0 Disinterment
!:\VVW-DATA\Ms-Cemetery\RECElPT.doo
and
Obituaries ~ Death Notices ~ Newspaper Obituaries ~ Online Obituaries ~ Newspaper D... Page 1 of 1
THOMAS MARTIN "TOM" SMITH
Thomas Martin "Tom" Smith, 48, died Sept. 24, 2008, at Holmes Regional Medical Center,
Melbourne. He was born in Utica, N.Y., and lived in Barefoot Bay for eight years, coming
from Vero Beach. He was a land surveyor. He was a Catholic. Survivors include his son,
Adam Smith of Vero Beach; mother, Pat Smith of Barefoot Bay; brother, David Smith of
Barefoot Bay; and fiance, Tanya Burgess of Barefoot Bay. He was preceded in death by
his father, Conrad Smith. Memorial contributions may be made to Leukemia & Lymphoma
Society of America Inc., 4360 N. Lake Blvd., #109, Palm Beach Gardens, FL 33410.
SERVICES: A memorial Mass will be celebrated at 10 a.m. Sept. 30 at St. Luke Catholic
Church, Barefoot Bay. Arrangements are by Strunk Funeral Home and Crematory,
Sebastian.
Published in the TC Palm on 9/25/2008
Today's TC Palm obituaries and death notices
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http://www.legacy.com/tcpalm/Obituaries.asp?Page=LifeStoryPrint&PersonID=11793... 9/30/2008
Sep 2F 2008 2;4SPt1 HP LF~SERJET 3200
FUNERAL DIRECT R'S REQUEST TO CITY OF SEBASTIAN
FbR BURIAL OPENI GIN SEBASTIAN MUNICIPAL CEMETERY
SE
r,o.~t G~ Ci~K/.ti iSUnD
Fo, lnfo,~rnstior contact:
Ki~7 Kc;tso - Ceme!ery Sexton
Serr~sti~~7Mu5B9A254 ernetery
Crty Clerk's U`fce
~iry Fl.t1f, 1225 Main Sfre®!
', Sebasrran, FL 32958
Oiflc' (T72) 388-8215 or 383-82 t 4
Fax: (772) 58S•55?G
FU~'~ERAL Hp(1rE Strunk Funer,~al Home >; Crematory
ADDRESS' 1623 N. Central Avenue, Sebastiat
P~iGNE #: 772-589-1000
(CheGc One )
~,QPE,ti" i3UR(Al. LOT
^~PEhI CREti1Al~"S LOT
OPEC! COL'JMBARIUM NICHE
BJRIAL DATE AND SERV~Cr `(IME
FCi~ DEGEASEC! Thomas Ma
Lp~ Block Unit
L~t ~-Block ~'- Unit ~-
Niche Siock Urt~t
~b 3 0~ - a ~ ~,o,~
Smith
r~~ar~~e
:`JANE AND SfGNAT.IRE OF LOT pWt~F_R OR REPRESEV?'AT;VE:
(".Iasi provide prpper documantaUcn of c;'wners_ri~} ,
Patricia A. Smith
9/29/08
'varne SignatJre pnta
I certify t,;at I have belemilned the ovvne't•ship vi the abo~re described ;its Ihal all site fees and
aaministrative fee, have been paid and ~uthori:e open,r~g of same
tyAi,1E AND SIG!v~,T RE. OF LICENSE? FU!JERA RE T
~ v ' ~~ ~a~
rvarne ~ Signature Dat?
__•.-~---------•---------------------------•-------i-._....__...._.._-•----------------------------•-----------~_......_
Cernelery Sexton Certification:
I certify t"at i havz ~hecKed the ovrr-ersr~ip ir~forrratrort b,~ viewing the owner's deed and confirming
with Clerk's pfiii E .trtd that all fens ha'rrv',been pa"d
• ~ ~ o~
Ge ter Sex on ~~ Gate
i
This forr7t to be provided to Clerk's Off.c~ by Sexton for permanent record ~~~un c0"~pleUOn.
p.l
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