HomeMy WebLinkAbout4-17-12Name AN -'FONT fR
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Date of of Mark•out 4 — — I `
Date of Burial y —10 l 1 `i
Name Funeral Home SCA
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Seawinds Funeral Home & Crematory
Antonia Maria Moya
Blanco
( June 13, 1942 - April 04, 2019 )
Antonia Maria Moya Blanco, 76, of
Sebastian, FL passed away April '0
2019.
The family will received guests at
Seawinds Funeral Home, 735 S. i
Fleming Street, Sebastian, FL 32958 on
Tuesday, April 9, 2019 from 4:00 to 8:00 pm.
A Funeral Mass will be held at St. Sebastian Catholic Church, 13075 U.S.
Hwy 1, Sebastian, FL on Wednesday, April 10, 2019, at 11:00 am. Burial
will follow at Sebastian Cemetery.
For directions and online guestbook please visit wwwseawindsfh.com.
Seawinds Funeral Home is honored to serve the Moya Blanco family.
CMOF
D - - '44
HOME OF PELICAN ISLAND
Certificate No. 2627
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:
Daniel Gonzalez & Vivian Diaz
706 W. Fischer Circle
Sebastian, FL 32958
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 17, Lot 12
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 5th day of April, 2019.
CITY OF SEBASTIAN, FLORIDA
-
Paul E. Carlisle
City Manager
ATTEST:
Wit �C Iu�YYJ�
inoette Wllliams, MClerk ' ->
MOF
SEAT--"
HOME OF PELICAN ISLAND
1225 Main Street
Sebastian, FL 32958
(772)589-5330 Phone
April 10, 2019
Mr. Daniel Gonzalez & Mrs. Vivian Diaz
706 W. Fischer Circle
Sebastian, FL 32958
RE. Interment Rights to Unit 4, Block 17, Lot 12, in the Sebastian Municipal Cemetery.
Dear Mr. Gonzalez & Mrs. Diaz,
Enclosed is City of Sebastian Certificate 2627 entitling you to full interment rights in
Unit 4, Block 17, Lot 12 in the name of Daniel Gonzalez & Vivian Diaz.
If you have any questions, please contact our office at 388-8209.
Sincerely,
Cat` y T sta
Records Clerk
Enclosure
State of Florida, Department of Health, Bureau of Vital Statistics
FIOf a BURIAL TRANSIT PERMIT
HFaTH DATE PRINTED: April 8, 2019 TRACKING NUMBER: 2019057088
1. DECEDENT INFORMATION
Name of Docomeal Dale of Death
ANTONIA MARIA MOYA BIANCO Apn14, 2019
Place of Death- County City, Town or Location Name of facility, or street address if not a facility
INDIAN RIVER SEBASTIAN SEBASTIAN RIVER MEDICAL CENTER
Name and Address of Funeral HomelDlmot Disposal Establishment Fla. Lic. NOJReg. No. Phone Number
SEAWINDS FUNERAL HOME F073380 F073380 (772)589-1933
735 SOUTH FLEMING STREET
SEBASTIAN. FLORIDA. 32958
Funeral DirectoHmrecl Disposer Fla. Lic. NOJReg. No.
P NICK VAN WAGENEN F044705
Medical Verification Statement
OMCs SMR at the certifying physician's office, case contacted on 0,W)SR019 by the funeral director listed above; he/she Indicated
Nal ENIO LUIS PRIETO. cars fying physician, will complete and Sign the medical Certification of cause of death within 72 hours.
2. BURIAL -TRANSIT PERMIT
The Florida Department of Health, Bureau of Vital Statistics
hereby grants permission to dispose of this body in accordance with Chapter 382, Florida Statutes.
Permit Number: 2019 1`073 50A
��— Date Issued: Ann[ 5, 2019
State Registrar
3. AUTHORIZATION for CREMATION, DISSECTION, BURIAL -AT -SEA, or HOSPITAL DISPOSITION
Authorization given by Medical Examiner District Approval Number:
4. CEMETERY OR CREMATORY
Placa of Disposition: SEBASTIAN CEMTERY / ^
Method of Disposition: eURIAL Date of Disposition: � �
EDRS maintains all statutorily required information regarding the death record and related
burial transit permit, therefore, returning the permit to the county health department is no
longer required.
If the Place of Final Disposition wishes to retain HIS copy of the permit for their file they may do so.
ON 326E. 10/12
64V-1011. Florida Admini9VoW. Coo,
CIV OF
Sts"PIAN
hWt OF zUXAF1 ISLAM
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 purchased I T
•.JAnItC-L �on12RL!✓2-1 VtVtan l�ir4Z
Name(s)
71 fit? FiSc&v2 NO -1r St6AST7AA) F� 3� i
Address
Area Code & Phone Number 4A
14.
Name & Residence Address of Intended Occupant if Other Than Purchaser
OFFICE USE ONLY
Receipt is acknowledged in the sum of:
LnNG--H46kS,A-7\�
on this 5L/1) dayof Ame—
Cemetery Lot(s) and/or Niche(s).
Unit `l' , Block I'7 , Lot(s) PLt
Dollars ($ ), 01�-b- co )
200 for the purchase of the following described
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: }�y,
Corner Markers (set of 4 - $20) Opening & Closina "� I • C C / w O H
Circle One
Vase and Ring for Niches (cost) Interment Disinterment
Temporary Marker Preparation & Installation
Signature o Purchaser
n TOTAL$
City of Sebast
The following documents were provided as Proof of
Residency:
IAWW-DATA\Ms-Cem eterylRECEIPT.doc I and
CITY OF SEBASTIAN 11673
ADMINISTRATIVE SERVICES RECEIPT
Name G. 1oNZALl-S, dCash
Date '7I 5l 111. O Check #
❑ 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 SubdivlsioNPlat Review
001501 329100 Zoning Fees
/,0I(71C 34-alim LCT I, 000. ca
OOISDI 3"526s OIG 4' I . 06
l )�K-t'1 1 -o -r 12,
eo
cam" Total Paid r 151"
Initials
White - Dept. of Origin -Yellow-Admin. Svcs. • Pink - Applicant