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- AN
ROME OF PELICAN ISLAND
Certificate No. 2057
CITY OF SEBASTIA
Certificate of Interment Rights
IN ACCORDANCE with provisions of the Code of Ordinances of the City of
Sebastian, it is hereby certified that:
Jewell F. & Stanley W. Steiner 754 Rolling Hill Dr., Sebastian, FI 32958
(name) (address)
in and for consideration of the sum of $1,400.00 is entitled to full interment rights in
the Sebastian Municipal Cemetery for the following plot:
Unit —4— Block _17 Lot(s)Niche(s)_32 & 33
of the Sebastian Municipal Cemetery,
as maintained on file in the records of the City Clerk
for use in accordance with the conditions, ordinances, resolutions, rules and regulations
prescribed therefore by the City of Sebastian.
CONVEYED THIS 3rd of January, 2006.
CITY
, FLORIDA
ATTEST:
)A17
7
aio, MMC
Clerk
Initials Total Paid
White - Dept. of Origin • Yellow - Finance • Pink • Applicant
CITY OF SEBASTIAN
CITY CLERKS OFFICE
�
3524
Name
❑Cash
Date
No.
Amount Paid
001001208001
Sales Tax
001501322900
Garage Sales
001501341920
Copies/Bid Specs.
001501341910
LDC /Code of Ordinances
001501341930
Election Quail yjng Fees
601010 343800
Cemetery Lob
/ ,
Lodi �
x=11
Block _L7_
Unit_y__
001501343805
Cemetery Fees
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Initials Total Paid
White - Dept. of Origin • Yellow - Finance • Pink • Applicant
CRY a6_S�%
SEBASTMN
HOME OF PELICAN ISLAND
City of Sebastian Municipal Cemetery
Purchase Receipt
To enable the City of Sebastian to determine .the correct rate, and in accordance with cemetery
rate regulations, residence of purchaser or person for whom lot is intended for interment must be
provided at time of purchase
Name(s)
Address
Area Code & Phone Number
Residence Address of Intended Occupant if Other Than Purchaser
Office Use Only
Receipt is acknowledged in the sum of:
ele
, Dollars ($
on this day of , 20p� for the purchase of the following
described Cemetery Lots nd /or Ni e(s).
Unit , Block , Lot(s) -�? V- 33 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 O H
Circle One
Vase and Ring for Niches (cost)
Signature of Purchaser
Interment
Disinterment
Service fees are to be paid at time of need only
I: \W W- DATA\Ms- Cemetery\RECEI PT.doc
1225 Main Street, Sebastian, F132958
Telephone (772) 589 -5330 — Fax (772) 589 -5570
January 3, 2006
Jewell F. & Stanely W. Steiner
754 Rolling Hill Drive
Sebastian, Fl 32958
Dear Mrs. Steiner:
Enclosed is City of Sebastian Certificate 2057 entitling you to full interment rights in Cemetery
Lot 32 & 33, Block 17, Unit 4. Also enclosed is a copy of the receipt and the Rules and
Regulations governing the Sebastian Municipal Cemetery.
If you have any questions, please contact our office.
Sin ,
Sally Mai 1,C
City Clerk
SAM:ar
enclosure