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HOME OF PEUCAN 1511�ND
Certificate No. 2010
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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:
Dottie Diana
(name)
72 Treasure Circle, Sebastian, Fl 32958
(address)
in and for consideration of the sum of $700.00 has purchased and is entitled to full
interment rights in the Sebastian Municipal Cemetery for the following plot:
Unit 4_ Block _13_ Niches_7b & 8b_
of the Sebastian Municipal Cemetery,
as maintained on file in the records of the City Clerk
for use in accordance with the conditions, ordinances, resolutions, rules and regulations
prescribed therefore by the City of Sebastian.
CONVEYED THIS 12th day of April, 2005.
CITY OF SEBASTIAN, FLORIDA
Jarnes A. Davis
Interim City Manager
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A. Maio, MMC
City Clerk
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RECEIPT � �. � : �
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Amount Paid � �>
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208001 Sales Tax � ' �<
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341920 CopieslBid Specs. � � '
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HOME dF +PEUCAN'ISWJD
City of Sebastian Municipal Cemetery
Purchase Receipt
To enable the City of Sebastian to determine the correct rate, and in accordance with cemetery
rate regulations, residence of purchaser or person for whom lot is intended for interment must be
provided at time of purchase
�-�a 7"T'� � c17✓ ANi9
Name(s)
�'Z T,�,�'A s4aE �'',;a �/�. ,_ ���sr;:�;_ ��. .��Rf'8
Ad d ress
77•2 - . S'89— J/oS
Area Code & Phone Number
Residence Address of Intended Occupant if Other Than Purchaser
O�ce Use Only
Receipt is acknowledged in the sum of:
.�i- - - ,l___ �.��...,Q �
Dollars ($ % o , o o )
on this /�,t� day of � , 20 a�for the purchase of the following
described Cemetery Lot(s) a d/or Niche(s).
N��3
Unit �_, Block �, �et(s);� , 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 %� � d C A�►� O H
Circle One
Vase and Ring for IViches (cost} Interment o�4, 4� Disinterment
T L $%�v�. aD
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Signature Purchaser ity of Sebastian
S�rvice fees are to be paid at time of need onl�
I:1W W-DATA\Ms-CemeterylRECEI PT.doc
CITY OF SEBASTIAN
CITY CLERK'S OFFICE � � � �
RECEIPT
Nama � a�
� Date � / .Z d G!-S� ❑ Check #
No. Amount Paid
001001208001 Sales Tax
001501322900 Garage Sales
001501341920 CopieslBid Specs.
001501341910 LDC/Code of Ordinances
001501341930 Election Qualifying Fees
601010 343800 Cemetery Lots 70d. DD
LoUNiche%��+�='L, Block /� . Unit �
001501343805 Cemetery Fees 9✓� �
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' Total Paid �pd
Initiais
White - Dept. of Origin • Yellow - Fin�aca • Pink • Applicant
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HOME OF FELiCAN ISIAND
1225 Main Street, Sebastian, Fl 32958
Telephone (772) 589-5330 — Fax (772) 589-5570
April 12, 2005
Mrs. Dotttie Diana
72 Treasure Circle
Sebastian, Fl 32958
Dear Mrs. Diana:
Enclosed is City of Sebastian Certificate 2010 for the purchase of Cemetery Niches 7b and 8b,
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.
Sincerely,
Sally A. Maio, MMC
City Clerk
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enclosure