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Certificate # 1938
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Certificate of Interment Rights
IN ACCORDANCE with provisions of the Code of Ordinances of the City of
Sebastian, it is hereby certified that:
Fortunato and Sandra Roma
(name)
433 Memorial Ave., Sebastian, F132958
(address)
in and for consideration of the sum of 1 400.00 has purchased and is entitled to full
interment rights in the Sebastian Municipal Cemetery for the following plot:
Unit 4_, Block _16 , Lot(s)_7 & 8_
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
OF
City Manager
14th day of January, 2004.
TEST:
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Sall A. Maio, CMC
City Clerk
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CITY OF SEBASTIAN
CITY CLERK'S OFFICE 2 4 5 3
RECEIPT "
Name'� ❑ Cash
Date / eck�?�;3,�,--
No. Amount Paid
001001 208001 Sales Tax
001501322900 Garage Sales
001501 341920 Copies181d Specs.
001501 341910 LDC/Code of Ordinances
001501341930 Election Qualifying Fees
601010 343800 Cemetery Lots ����
LoUNiche�, Biock �� , Unit�
001501 343805 Cemetery Fees �—�
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Total Paid �y�-�„"°`
Initials
White – Dept. of Origin • Yellow – Financa • Pink - Applicant
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