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HomeMy WebLinkAbout4-10-16QTY of ._:- :: HOME OF PELICAN ISLAND Certificate No. 2197 Certificate of Interment Rights IN ACCORDANCE with provisions of the Code of Ordinances of the City of Sebastian, it is hereby certified that: Nancy George Michaud 805 Holden Court, Sebastian, FL 32958 (name) (address) In and for consideration of the sum of $2,000.00 is entitled to full interment rights in the Sebastian Municipal Cemetery for the following lots: Unit 4, dock 10, Lots 15 & 16 of the Sebastian Municipal Cemetery, as maintained on file in the records of the City Clerk for use in accordance with the conditions, ordinances, resolutions, rules and regulations prescribed therefore by the City of Sebastian. CONVEYED THIS 7th day of November, 2008. CITY ~F SE~/,~~fIAN, FLORIDA inner anager ATT--I : °~ ~_ Sally. .Maio, MMC City Clerk €rtY t~ ~l ~'- ~ ~ a" FiUME ©F PELICAN fStAtdF? City of Sebastian Municipal Cemetery Purchase Receipt To enable the City of Sebastian to determine the correct rate, and in accordance with cemetery rate regulations, proof of City residency of purchaser or person for whom lot is intended for interment must be provided at time of purchase. Names ' J ~n 5 ~d (d~-1~ C~ t,,~r-t~ ~S~bas ~f ~ a,~ ~L .3z ~ 5 ~ Address C ~ 7 ~- Area Code & ? Co 3 3 ~- ~- I b 0 Number Name & Residence Address of Intended Occupant if Other Than Purchaser OFFICE USE ONLY Receipt is acknowledged in the sum of: Dollars ($ Q~~ ~ ~ on this- ~ day of N~t~ , 20~~ for the purchase of the following described Cemetery Lot(s) and/or Niche(s). i Unit ~, Block ~_, Lot(s) ~ JC ~i ~lP 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) Vase and Ring for Niches (cost) Interment /W O H Circle One Disinterment Temporary Marker Preparation & Installation I61 Sin r of Purchaser L•\WlN-DATA1lVls-Cemetery\RECEIPT.doc and The following documents were provided as Proof of Residency: Opening & Closing TOTAL $ oL~O~ , ~~ o City of Sebastian CITY OF SEBASTIAN CITY CLERK'S OFFICE 4 2 O b RECEIPT Name ! 1v(~~~ ' ' 4 ~ ~~ ~ ~°`~~ ^ Cash Date ` [ _ ~ ~ ~ ~ ,Check # No. 001001208001 001501 322900 001501 341920 001501 341910 001501 341930 601010 343800 001501 343805 Amount Paid Sales Tax Garage Sales Copies/Bid Specs. LDC/Code of Ordinances Election Qualifying Fees h `,~^ ~/~ Cemetery Lots t /~ /~j LoUNiche f ~'~ ` Y/, Block ~ ~° ,Unit Cemetery Fees ~~~~~1 ~~~ ~~~ Total Paid Initials White -Dept. of Origin • Yellow -Finance • Pink • Applicant