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Certi�cate # 1939
Certificate of Interment Rights
IN ACCORDANCE with provisions of the Code of Ordinances of the City of
Sebastian, it is hereby certified that:
Michael Latham 106 Thunderbird Drive, Sebastian, FZ 32958
(name) (address)
in and for consideration of the sum of 350.00 has purchased and is entitled to full
interment rights in the Sebastian Municipal Cemetery for the following plot:
Unit 4_, Block 13 , Lot(s)_7a _
of the Sebastian Municipal Cemetery,
as maintained on �le 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 January, 2004.
CITY OF
City Manager
, FLORIDA ATTEST:
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Sall `� Maio, CMC
City Clerk
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Name ��� � �%.�� �� _—_ ��lv 1 �i!�!_ __ ____!'-h %�� ' �i����l��: -
Unit
Block / �✓
Lot �'�
Date of Mark-out I� f.7 '��
Date of Burial � y � � T � � Time � � r, �� �"Y�� �
Name of Funeral Home ���� �!'J- i�/ ��
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Authorized by - ' ° - '' ^
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HOME OF PELIUN ISWVD
City of Sebastian Municipal Cemetery
Purchase Receipt
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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
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Name(s)
i o(� ?ltiu����. �O� �.� �� vc� S� �AS� ��, F�( 3G � s",8
Address
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Area Code & Phone Number
Residence Address of Intended Occupant if Other Than Purchaser
Office Use On/y
Receipt is acknowledged in the sum of:
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44.s �►
Dollars ($ 3 Sp. ,� � )
on this day of , 20 for the purchase of the following
described Cemetery Lot(s) and/or Niche(s).
Unit �, Block � 3 , Lot(s) % p 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 �„� ,Q"J ( W 1 O H
ircle One
Vase and Ring for Niches (cost)
Signature of Purchaser
Interment '�� 0� Disinterment
T AL $—���•5/ d d
�% /
ity of Sebastian
Service fees are to be paid at time of need only
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January 19, 2004
Mr. Michael Latham
106 Thunderbird Drive
Sebastian, F132958
Dear Mr. Latham:
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Enclosed is City of Sebastian Certificate Number 1939 for the purchase of Lot Number 7a,
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 conta.ct our office.
Sincere
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Sa11y A. Ma�o, CMC
City Clerk
SAM:ar
enclosure
CITY OF SEBASTIAN
���R���FF�E . 2454
.
Name ❑ Cash
Date � O eck i�,2�
No. Amount Paid
001001208001 Sales Tax
001501322900 Garage Sales
001501341920 CopieslBid Specs. �
001501341910 LDCICode of Ordinanoes
0015013d1930 Election Qualii�ring fees
601010 343800 Cemetery LoLs .�7 a. D �
LoUNkhe �ti_, Blodc �, Unk �
OOt501 343605 Cemetery Fees J•��
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Tot�i� � ��O
In als ��
White - Dept. of Origin • Yellow - finmce • Pink • Appliunt
SEAWINDS FUNERAL HOME
735 FIEMING STREET
SEBASTIAN, FL 32958
F PAY
TO THE �.,
� ORDER OF
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Name
I���7�
CITY SEBASTIAN
CtTY C RK'S OFFICE
No.
001001 208001 Sale Tax
001501322900 Garage les
001501341920- CopieslBid .
001501341910 LDC/Code of Orcl
001501 341930 Electlon Qualifying
601010 343800 Cemetery Lots
001501343805
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Amount Paid
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Initials .
White - D�pt of Origin • Yall - Fin�nee • Pink • Appliemt
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� 3696
� 83-843/870
DATE � 1� � 1� J� ewwcH e�s�e
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� �� DOLLARS � F ^N"
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� WACHOVIA ^
Wachovia 8ank, N.A. �
ACH R/T087008432
��'003696��' �:06700643 2�:200000948
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