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HOME OF PELICAN ISLAND
Burial rights in the Sebastian Municipal Cemetery lots/niches purchased by me
Lindy ari sfrno n, 72 ,E Tuxedo Trrace, SehQsf ah rt
(Please print name and address of purchaser) 3Z9 5,
ttWi if q, B / k 13 , Lot 5 cc
(Lot/niche, block, unit description)
are intended for interment of the following individuals:
Please print name(s):
1 c b er f P i io e .S (c + r)
OOLble, i terrner\f
-nGZ K)+ pe s ( o+hr) Pro4 10 � " C ify ,
ie 5a. y Maio, maic
C.( Clerk,
Interment lots/niches are not to be transferred without written approval of the City of
Sebastian. Interment lots/niches in the Sebastian Municipal Cemetery are allowed to be
passed on to heirs but the City requires a certified copy of relevant probate or other
court documents.
I haveAread and understand the terms of this agreement.
rl
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615/0q
Signature Date / 7
S bscribed and sworn to before me this / 54 * day of Catcher , 2 013, by
i h i C. r I5'/Ma. who is personally known to me, or has produced
C ITIftrieff C A as identification.
Al i A , ' I . / ,
tary Public, tate of Florida _
JEANE WIWAMS
Names of Interred form �,M: EU
s us Commission#EE 038067
ta- --,kri Expires February 28,2015
14:,,;e Bonded TMu Troy Fan Iri.aance800-37019
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FIt3ME t)� PELi�AN ISIAND
Certificate # 1913
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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:
Linda Christman 725 Tuxedo Terrace, Sebastian, F1 32958
(name) (address)
(name)
(address)
in and for considera.tion of the suxn of � 3 5 0. o o , has purchased and is entitled to full
interment rights in the Sebastian Municipal Cemetery for the following plot:
Unit 4 , BIoCk 13 , LUt(S) 5 a
of the Sebastian Municipai 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 Sebastia.n.
CONVEYEDTHIS 3rd �ypf September , 2003 .
�,iry ivlanager
A'
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Sally A. 'o, CMC
City Cl
�
Name �Q� � � � �� k' �� l� � � �
U�it
Block 1 .:✓
Lot = 3 � �
Date of Mark-out _�� �� � ,..��
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Date of Burial � `� ���'' � � Time � ` ��� �C` `� ►
Name of Funerat Home � ����_� �
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Authorized by -
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S�BAST1�
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HOME Of �PEUCAN IStAND
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City of Sebastian Municipal Cemetery
Purchase Receipt
,�.�.
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To enable the City of Sebastian to deternune 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
�. i N d c� G� R i ST nr� A�
Name(s)
��5 rr-uxEcl,o TE�. SE�AS-r,Aa , �f 329s�s
Address
'T'i2- S8!- o4�O�o
Area Code & Phone Number
Residence Address of Intended Occupant if Other Than Purchaser
O�ce Use On/y
Receipt is acknowledged in the sum of:
.
���� ��' �-/� `--L-
Ilars ($� � , o o )
�/0 /
on this d"ay of , 20 Q3 for the purchase of the following
described Cemetery Lot(s) a/or Niche(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 '/,�, d d W O H
� Circle One
Vase and Ring for Niches (cost) Interment �D. o v Disinterment
$ DO
Signature of Purchaser
of Sebastian
Service fees are to be paid at time of need only
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CITY OF SEBASTIAN '
CtTY CLERK'S OFFICE 2 Q 5 4 '
' RECEIPT '
�.s�/rr1 e ,s�'..�I
Name Cash '
Date eck #�D % % '
No. Amount Paid
001001208001 Sales Tax
001501322900 Garage Sales
001501 341920 CopieslBid Specs.
001501341910 LDC/Code of Ordinances
001501341930 Election Qualifying Fees
601010 343800 Cemetery Lots � '
LoUNicheJ ,[� . Bbdc �✓ . Unit� I
001501 343805 Cemetery Fees �, O� ',
� E.�'%`a�.., �OE.2J'� �'�ES�
✓Total Pai� Dd '
IniUals
White - Dept of Origin • Yellow - Financa • Pink • Applicant
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HOME OF PELICAN ISWVD
September 5, 2003
Linda Christman
725 Tuxedo Terrace
Sebastian, Fl 32958
Dear Ms. Christman:
Enclosed is City of Sebastian Certificate Number 1913 for the purchase of Cemetery Lot Sa,
Block 13, 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.
Sin ly,
�y �
�
Sally . aio, CMC
City Clerk
SAM:ar
enclosure