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Home My WebLink About4-15-190 J �� S��T�� HOME OF PEUCAN iSUND Certificate No. 2037 �� Certificate of Interment Rights IN ACCORDANCE with provisions of the Code of Ordinances of the City of Sebastian, it is hereby certified that: Tannie Gressinger 745 E. Fischer Circle, Sebastian, Fl 32958 (name) (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 19 of the 5ebastian 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 25th day of August, 2005. TIAN, FLORIDA * ATTEST: Gc.�,��',c��.'�r►�J Jeanette Williams, CMC Deputy City Clerk 0 � 0 � ,. , .. . n ,. .� � .��::��. .� : . . � .� Name "• Unit Block S Lot /"l Date of Mark-out �/�/��' Date of Burial G.�� ' Time : oo � Name of Funeral Home 5 csw/�- Authorized by �,(il�.�,(.1,� W ��'��. �s &' m � � 0 i .� � �. �. � . < � � T 7 m � � r ...� � 7 � � � � w ^. O 0 0 8 F3 S 8 8 8 S o ; p � j � O O O O � � � � � � � � � � � g �, g �' o 0 �O la c�n m � o d °�' � � � � � � � � �, � � � � � o � � � � _� � $ -� ,� � . T � � � � � V � l � z Y � 1 � � l � N � r. c � � � S�p Y {'1 „ � �, S � � � w � o � o � �� o A � m �o� T � T C � _ m � � � 0 --- � BETrY JANE MCCOY Mrs. Betty Jane McCoy, 77, died May 31, 2012 at Indian River Medical Center, Vero Beach. She was born May 28, 1935 in Elkhorn, West Virginia and lived in Sebastian for 9 years coming from Stuart, Florida. She was a member of King's Baptist Church. Survivors include her daughters, Tannie Gressinger of Sebastian, Deborah Wilkinson of Sebastian, Jamie Irvin of Hope Sound, 8 grandchildren and 4 great-grandchildren. She was preceded in death by her husband Vernon in 2005. - -� ELdRi.pADII'ARC61�VLqF: �.' State of Florida, Department of Health, Bureau of Vital Statistics H��LT BURIAL TRANSIT PERMIT DATE PRINTED: June 5, 2012 TRACKING NUMBER: 2012075340 � • DECEDENT INFORMATION Name of Deceased Date of Death BETTY JANE MCCOY May 31, 2012 Place of Death - County City, Town or Location Name of facility, or street address if not a facflity INDIAN RIVER VERO BEACH INDIAN RIVER MEDICAL CENTER Name and Address of Funeral HomelDirect Disposai Establishment Fla. Lic. No./Reg. No. Phone Number STRUNK FUNERAL HOME- SEBASTIAN F041870 F041870 1623 N CENTRAL AVE (772) 589-1000 SEBASTIAN, FLORIDA, 32958 Funeral DirectoNDirect Disposer T�MOTHY W. MARVIN Fla. Lic. NoJReg. No. F022789 2• BURIAL - TRANSIT PERMIT The Florida Department of Health, Bureau of Vital Statistics hereby grants permission to dispose of this body in accordance with Chapter 382, Fiorida Statutes. Permit Number: 2o�2-FOa�s7o-5o�s , aG� �,r ' Date Issued: June 5, 2012 J ,� Meade Grigg, State Registrar 3. AUTHORIZATION for CREMATION, DISSECTION, BURIAL-AT-SEA, or HOSPITAL DISPOSITION Authorization given by Medical Examiner District Approval Number: 4• CEMETERY OR CREMATORY Place of Disposition: SEBASTIAN CEMETERY ��t�� _ Method of Disposition: BURIAL Date of Disposition: • � . /% o�yn�cure o�sexcon or perso�-charge (or by the funeral d�rector/direct disposer when there is no sexton) DH 326E, 1/11 64V-1.011, Florida Administrative Code � `+ ' � � FUNERAL DIRECTOR'S REQUEST TO CITY OF SEBASTlAN FOR BURIAL OPENING IN SEBASTtAN MUNICIPAL CEMETERY � �a�� For information contac:t: Kip Kelso - C�mefery Sexton Sebastian Municfpal Cemetery (772) 589-2545 City Clerk's O�ce City Hall, 1225 Main Strest Sebastian, FL 32958 Qffice (772} 38&8295 a' 388-8214 Fax: 72 589-5570 STRUNK �UNERAL O�E & CREMA�ORY FUNERAL HOME: 1623 No. Central Ave. ADDRESS: (�) ggg.�ppp PHONE #: !�( h One) � OPEN BURIAL LOT Lot �� Biock �5 Unit OPEN CREMAINS LOT Lot Block Unit OPEN COLUMBARIUM NlCHE Niche Block Unit N S E W �j�� BURIAL DATE AND SERVICE TIME: �DO /�y"I FOR DECEASED: ��-� NI CI�UC�� Name NAME AND SIGNATURE OF LOT OWNER OR REPRESENTA' �Must provide proper documentati4n of ownership) �G1nI�l�. (.LS� ( � Name ' n ure �� Date I certify that I have determined the ownership of the above described site, that alf site fees and administrative fees have been paid and authorize opening of same. � AND SIGNATURE OF LICENSED F�I,ERAL DI TOR: � � (..1�V V 1� � � � Util � I � 1� �VI/l.� �� I a- Name Signature pate Cemetery Sexton Certification: �M—'��'�'��~�M I certify that i have checked the ownership inforrnation by viewing the owner's deed and confirming with CEerk's office and at all fees have been paid: - , 7i. Cem �ery xton Date This form to be provided to Clerk's Office by Sexton for permanent reCard upon cornpletion. �# �� : _� � HOME OF PELICAN ISLAND 1225 Main Street, Sebastian, F132958 Telephone (772) 589-5330 — Faac (772) 589-5570 August 25, 2005 Mrs. Tannie Gressinger 745 E. Fischer Circle Sebastian, Fl 32958 Dear Mrs. Gressinger: Enclosed is City of Sebastian Certificate 2037 for the purchase of Cemetery Lot 19, 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. Sincerely, Wi[.� � anette Williams, CMC Deputy City Clerk JW:ar enclosure �a S�B��'�V � y�� HOME OF PFLiUN ISWVD City of Sebastian Municipal Cemetery Purchase Receipt �° 3 7 � 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 .�— fy. /�A�A�/ E� .!sY` ��E•�i /J GE%�P. Name(s) /' ` - ��5' �E ,r�� .2�% �.�.s�3-�.9.v_ �L .��'�s`8 Address Area Code & Phone Number Residence Address of Intended Occupant if Other Than Purchaser Office Use Only Receipt is acknowledged in the sum of: �� on this �.�.� day of described Cemetery Lot(s) an r Niche(s). lars ($ �o_ a a ) 20v5' for the purchase of the following Unit �_, Block /s , Lot(s) f y' Niche(s) for use in accordance with the conditions, ordinances, resolutions, rules and regulaiions 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 ity of Sebastian W O H Circle One Disinterment TOTAL $ %O'o - o d Service fees are to be paid at time of need only I:\W W-DATA\Ms-Cemetery\RECE I PT.doc cmroF sEensTaN 3 4 01 '� • 'CITY CLERK'S OFFICE ! RECEIPT i ✓ ' ` i Name � a C�sh s'— /OD I Date � O �k 0 AmouM Paid I� No. ; 001001208001 Sales Tax I 001501322900 Gara9e Sales �� i 001501341920 CoPieslBid SPecs• � 001501341910 LDCICode of Oi'dinences 001501341930 Electlon �uaU(y�tg Fees �/ 601010 343800 Cemetery Lob �� d� LotMk��e ��a Blodc � � . Unft � 001501343805 Cemelery Fee.a ��44. o d • � Total Paid InlWls Whit� - Dpt of OriOin • Y�Ilow - Financ� • Pink • Appliant