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Certificate # 1911
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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:
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-Barbara McC1~re 1380 Haverford Lane, Sebastian, F1 3T958
(name)
(name)
(address)
(address)
in and for consideration of the sum of $1 , 4 0 0.0 0 ,has purchased and is entitled to full
interment rights in the Sebastian Municipal Cemetery for the following plot:
Unit 4 ,Block 15 ,Lot(s) 11 & 12
of the Sebastian Municipal Cemetery,
as maintained on file in the records of the City Clerk
for use in accordance with the conditions, ordinances, resolutions, rules and regulations
prescribed therefore by the City of Sebastian.
CONVEYED THIS 2 6th day of August , 2 0 0 3
C Y OF S AST FLORIDA ATT ~
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Terrence oore Sally A. o, CMC
City Manager City Clerk
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HOi4[E OF PEUUN 15IAND
City of Sebastian Municipal Cemetery
Purchase Receipt
To enable the City of Sebastian to determine the correct rate, and in accordance with cemetery
rate regulations, residence of purchaser or person for whom lot is intended for interment must be
provided at time of purchase
Residence Address of Intended Occupant if Other Than Purchaser
OfiFice Use Only
Receipt is acknowledged in the sum of:
Dollars ($ Go _ z} ~ )
on this ~~ tlay of ~~ , 20 ~3 for the purchase of the following
described' Cemetery Lot(s) an r Niche(s).
Unit T ,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 ~S~' ~ W O H
Circle One
Vase and Ring for Niches (cost) Interment , ~ Disinterment
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Signature of Purchaser City of Sebastian
Service fees are to be paid at time of need only
1:1W W-DATA1Ms-CemeterylRECEIPT.doc
Area Code & Phone Number
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CITY OF SEBASTIAN
CITY C RECE pOFFICE ~ ®~
Name
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^ Cash
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No. Amount Paid
001001 208001 Sales Tax
001501322900 Garage Sales
001501341920 CopieslBid Specs.
001501 341910 LDC/Code of Ordinances
001501 341930 Election Qualifying Fees
601010 343800 Cemetery Lots ~(1- ~~~
Lot/Niche 1 /~T-, Block f~ ,Unit
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001501 343805 Cemetery Fees %
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Total Paid ~,,''~d
Initials
White -Dept. of Origin • Yellow -Finance • Pink • Applicant