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HomeMy WebLinkAbout4-13-35aIN ACCORDANCE with provisions of the Code of Ordinances of the City of Sebastian, it is hereby certified that: Andrew /or Anita Herbst 205 S. Wimbrow Drive, Sebastian, FL 32958 (name) (address) In and for consideration of the sum of $1,000.00 is entitled to full interment rights in the Sebastian Municipal Cemetery for the following Tots: Unit 4, Blk 13, Lots 34a 35a 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 16 day of October, 2009. CITY OF S ASTIAN, FLORIDA I Minner City Manager CITY OF HOME OF PELICAN ISLAND Certificate No. 2239 CITY OF S ASTIAN Certificate of Interment Rights ATTEST: Sally Maio, MMC ity Clerk Corner Markers (set of 4 $20) Vase and Ring for Niches (cost) Signature of Purchaser I: \W W- DATA \Ms Cemetery \RECEIPT.doc S A F HOME OF PELICAN ISLAND 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. d,re-w Ant fa P erbsf Name(s) SbaSti c-' FL 3ZQ 5 �D5 5. �,�,lrrnbrvw �r� ve,, Address 772. 5T-?7Eq Area Code Phone Number Name Residence Address of Intended Occupant if Other Than Purchaser OFFICE USE ONLY Receipt is acknowledged in the sum of: QY1L aria gl ite A Dollars 6 00,00 on this 5'' day of Oat 19e,r 20 Dq for the purchase of the following described Cemetery Lot(s) and /or Niche(s). Unit Block 13 Lot(s)3(4,2. 4. 3 5a. 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: Temporary Marker Preparation Installation Opening Closing W 0 H Circle One Interment Disinterment The following documents were provided as Proof of Residency: and 41111 ty of Sebastian TOTAL /DD O, 00 Herbs Date /o /5 0 6 Name No. 001001 208001 001501 322900 001501341920 001501 341910 001501341930 601010 343800 001501 343805 CITY OF SEBASTIAN CITY CLERK'S OFFICE RECEIPT Sales Tax Garage Sales Copies/Bid Specs. LDC /Code of Ordinances Election Qualifying Fees Cemetery Lots Lot/Niche3Ae3 /3 Cemetery Fees Initials White Dept. of Origin Yellow Finance Pink Applicant 4601 Cash )(Check# /59 Amount Paid Unit �T Total Paid /40430 o I i1 /7/4,86 57_ A#D •et fix, is 5 r i3 Cc,ei,.o AVAILABLE FOR SALE UNIT BLOCK ,(i LOT/NICHE.3- 0---