HomeMy WebLinkAbout4-15-05
Q]Y OF
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HOME OF PELICA[V ISLAND
Certificate # 1937
Certificate of Interment Rights
IN ACCORDANCE with provisions of the Code of Ordinances of the City of
Sebastian, it is hereby certified that:
Clementina A. Scott
(name)
183 Caprona Street, Sebastian, Fl 32958
(address)
in and for consideration of the sum of $700.00, has purchased and is entitled to full
interment rights in the Sebastian Municipal Cemetery for the following plot:
Unit _ 4_, Block _15 , Lot(s)_ 5_
of the Sebastian Municipal Cemetery,
as maintained on file in the records of the City Clerk
for use in accordance with the conditions, ordinances, resolutions, rules and regulations
prescribed therefore by the City of Sebastian.
CONVEYED THIS 12th day of January, 2004.
C Y OF SE$ASTIAN, FLORIDA
~,
errence ~: lvroore
City Manager
TEST:
~.
Sall .Maio, CMC
City Clerk
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HCA'~ OFf PELIUN 15LRND
City of SeE~astian 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
~/Ji9 a/C
Name(s) ~ .
Address
77Z -~1 ~B''vTi° 7~
Area Code & Phone Number
Residence Address of Intended Occupant if Other Than Purchaser
O1Fifice Use Only
Rece' is acknowledged in the sum of:
o ~~
Dollars ($ ~~0~ a a )
on this ~~~,~c. day o , 200 for the purchase of the following
described Cemetery Lot and/or N' e(s).
Unit ~_, Block ~, Lot(s)_~ -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
Vase and Ring for Niches (cost) Interment
`'
Signature of Purchaser ty of Seb
Service fees are to be paid at time of need only
W O H
Circle One
Disinterment
b\W W-DA?A\Ms-CemeterylRECE1PT.d oc
C~IY Of'
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HOME OF PELiChN ISLhND
January 12, 2004
Ms. Clementina A. Scott
183 Caprona Street
Sebastian, Fl 32958
Dear Ms. Scott:
Enclosed is City of Sebastian Certificate Number 1937 for the purchase of Lot Number 5,
Block 15, 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.
Sinc ely,
~%C. L ~~ ._..
Sally A. aio, CMC
City Clerk
SAM:ar
enclosure
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CITY OF SEBASTIAN
CITY CLERK'S OFFICE ~ 2 4 4 ~
RECEIPT '
Name u" ^ Cash
Date / C heck# /9.~~
No. Amount Paid
001001 208001 Sales Tax
001501 322900 Garage Sales
001501341920 Copies/Bid Specs.
001501 341910 LDCICode of Ordinances
001501 341930 Election Qualifying Fees
601010 343800 Cemetery Lots ~7/l~ Db
LoUNiche ~ .Block ~S .Unit
001501 343805 Cemetery Fees
Total iP5 d !~d ~~
Initials
White - Oept. of Origin • Yellow -Finance • Pink • Applicant