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HOME OF PELICAN ISWVD
Certificate # 1952
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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:
Gregory R. and/or Irma E. Golien 71l Wimbrow Drive, Sebastian, FZ 32958
(name) (address)
in and for consideration of the sum of 3 500.00 has purchased and is entitled to full
interment rights in the Sebastian Municipal Cemetery for the following plot:
Unit _ 4_ Block _16 , Lot(s)_36, 37, 38, 39, & 40_
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 30th day of March, 2004.
Y OF SE '�'IAN, FLORIDA ATTE�T:
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�rren ��. oore Sa A. Maio, CMC
City anager City Clerk
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Apri19, 2004
To: Superintendent, Sebastian Municipal Cemetery
�,ttective this date,l hereby donate the lots m Sebastian Mumcipal C;emetery described as
Unit 4, Block 16, Lots 3b and 37 to Gary and Eileen Golien (Mr. and Mrs. Gary Golien),
currently residing at 1401 Penny Court, Tavares, FL 32778.
Sincerely,
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HOME OF PELIUN ISWVD
City of Sebastian Municipal Cemetery
Purchase Receipt
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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
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Name(s) J i
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Add�ess J I ^
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Area Code & Phone Number
Residence Address of Intended Occupant if Other Than Purchaser
Office Use Only
Receipt is acknowledged in the sum of:
Dollars (�S�o.od )
on this�„��� day of 4 , 20� for the purchase of the following
described Cemetery Lot(s and/or Niche(s).
Unit �, Block��, Lot(s�d,d7.���9,� Niche(s)
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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)
Si�atuG#k,4f Purchaser
a �
ity of ebastian
Disinterment
Service fees are to be paid at time of need only
I:\W W-DATA\Ms-CemeterylRECEI PT.doc
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H�ME C3F PELiCAN iSU►Nm
April 2, 2004
Gregory R. & Irma E. Golien
711 Wimbrow Drive
Sebastian, FI 32958
Dear Mr . & Mrs. Golien:
Enclosed is City of Sebastian Certificate Number 1952 for the purchase of Cemetery Lots 36, 37,
38. 39. & 40, Block 16, 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.
Sincerely,
Sally A. Maio, CMC
City Clerk
SAM:ar
enclosure
CITY OF SEBASTIAN
CITY CLERK�S oFF��E 2 6 7 6
RECEIPT
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Name 4'�� - x�'�'"—'❑ Cash
Date � em�Gh ck # 9��
No. Amount Paid
001001 208001 Sales Tax
001501 322900 Garage Sales
001501341920 CopieslBid Specs.
001501 34191C LDC/Code of Ordinances
001501341930 Election Dualifying Fees �
601010 343800 Cemetery Lots .7y�/J�D, d d
��Nic'f��� Block /G . Unit�
001501 343805 Cemetery Fees
Total Pa'�7 Dd , d d
Initials '
White - Dept. of Origin • Yellow - Finance • Pink • Applicant
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