HomeMy WebLinkAbout3-COL-18DsCertificate No. 2202
Certificate of Interment Rights
IN ACCORDANCE with provisions of the Code of Ordinances of the City of
Sebastian, it is hereby certified that:
Carmella Phillips 401 Banyan Street, Sebastian, FL 32958
(name) (address)
In and for consideration of the sum of $2,000.00 is entitled to full interment
rights in the Sebastian Municipal Cemetery for the following niche:
Unit 3, COL, Niche 18 D/S
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 22"d day of January, 2009.
CITY~OFBASTIAN, FLORIDA
/.
~~ CAI Minner
~ City Manager
ATT ( ~j
` ' ~ t ~...
Sall A. Maio, MMC
City Clerk
Name t* ~~' /w'J ti ~~ ~
Unit
~.-
Block• ~~~'~
Lot /~ ~ tC~ ~ /s
Date of Mark-out
1'..- ids,`- ~.
Date of Burial ~ ~~ ~~ ~ Time
Name of Funeral Home ~ /
Authorized by ~".~~~''" "` " ' ~'~
Name
r
Unit
Block
Lot ,r °~~ ~-'"
Date of Mark-out '~..
~5 / U ` ~ Time ~~ ~~ ~ • I~~'7P ~
Date of Qurial
Name of Funeral Home { ~ fi'n' "~ `.~
/~ r
t.~`s~-~-'h'7.'4-''~
Authorized by
FUNERAL DIRECTOR'S REQUEST TO CITY OF SEBASTIAN
FOR BURIAL OPENING IN SEBASTIAN MUNICIPAL CEMETERY
:,~
NOME OF PELICAN ISLAND
For information contact:
Kip Kelso -Cemetery Sexton
Sebastian Municipal Cemetery
~ - ~ (772) 589-2545
~~- -
~ ~ City Clerk's Office
- I City Hall, 1225 Main Street
Sebastian, FL 32958
v Office (772) 388-8215 or 388-8214
_ - Fax: (772) 589-5570
FUNERAL HOME: ~`'~w~~~,S' ~-~
ADDRESS: ~.3
~( ~2 ~f~
PHONE #: CJg~1-~%33 ~
(Check One)
OPEN BURIAL LOT Lot Block Unit
OPEN CREMAINS LOT Lot Block Unit
OPEN COLUMBARIUM NICHE Niche ~ Block Unit ~-
N S E W
BURIAL DATE AND SERVICE TIME: Sfi- /`0 9 ~'. 3 0 ~ J'g; -
FOR DECEASED: ~ ~`j! f l ~~f
N
AME AND SIGNATURE OF LOT OWNER OR REPRES TATIVE:
(M rovide pro doa entation of ownershi)
r`,S ~, 7 10
_~~
Name Signature Date
I certify that I have determined the ownership of the above described site, that all site fees and
administrative fees have been paid and authorize opening of same.
NAM(E~AND SIGNAfTURE OF LICENSED FUNERA (RECTOR:
c~+~9-N. ~O b u ~ Z a~o
Name i ature ~ Date
------------------------------------------------------------------------------------------------------------------------------
Cemetery Sexton Certification:
I certify that I have checked the ownership information by viewing the owner's deed and confirming
with Clerk's office and that all fees have been paid:
~~
Ce~exton Dat
rY e
This form to be provided to Clerk's Office by Sexton for permanent record upon completion.
FUNERAL DIRECTOR'S REQUEST TO CITY OF SEBASTIAN
FOR BURIAL OPENING IN SEBASTIAN MUNICIPAL CEMETERY
:,~..
SE~?!AN
HOME OF PELICAN ISLAND
For information contact:
Kip Kelso -Cemetery Sexton
Sebastian Municipal Cemetery
~ - ~ (772) 589-2545
~-_ _
~ ` ~ City Clerk's Office
City Hall, 9225 Main Street
Sebastian, FL 32958
v Office (772) 388-8215 or 388-8294
Fax: (772) 589-5570
FUNERAL HOME:
ADDRESS
..~~u as j:' ~
s I''l~m~~a .S
PHONE #: ~~q- ~~1'33 J
(Check One)
OPEN BURIAL LOT
OPEN CREMAINS LOT
-OPEN COLUMBARIUM NICHE
BURIAL DATE AND SERVICE TIME:
Lot Block Unit
Lot Block Unit
Niche 1 !7 S Block Unit 3
N S E W
~=i~oy ~: soo
FOR DECEASED: ~:~ (~~2!'1'~E7lA
Name
AME AND SIGNATURE OF LOT OWNER OR REPR SEN TI E:
(Must provide proper documentation of ownership
~'~. its ~~.~ l l , ~A1 ~ ~ 7 ~ l
Name Signature D to
I certify that I have determined the ownership of the above described site, that all site fees and
administrative fees have been paid and authorize opening of same.
NAME AND SIGNATURE OF LICENSED FUNERAL DIRECTOR:
Name ~gnature ~ Date
------------------------------------------------------------------------------------------------------------------------------
Cemetery Sexton Certification:
I certify that I have checked the ownership information by viewing the owner's deed and confirming
with Clerk's office and that all fees have been paid:
Cemetery Sexton
PG-~~I~~o
Date
This form to be provided to Clerk's Office by Sexton for permanent record upon completion.
Carmella Maria Phillips
Carmella Maria Phillips, 88, died July 26, 2009, at William Childs
Hospice House in Palm Bay. She was born in Italy and lived in
Sebastian since 1999, moving from Hollywood. She was a retired
waitress. She worked for Westview Country Club for more than 30
years and volunteered with the Red Cross, the food banks, Our Lady of
Guadalupe, Sebastian River Medical Center auxiliary, and several thrift
stores. Survivors include her son, Christopher Phillips of Atlanta;
daughter, Jennifer Reilly of Fort Lauderdale; brothers, Albert DeFilippo
of Ocala and Joseph Phillips of Sebastian; sisters, Josie Cannon of
Stuart, Eva Lewis of Sebastian, Marie of Sebastian and Teresa
Goldsmith of Chicago; two grandchildren; and four great-
grandchildren. She was preceded in death by her husband, Roy L.
Phillips; and sister, Cathy DeFilippo. Memorial contributions may be
made to William Childs Hospice House, 381 Medplex Parkway, Palm
Bay, FL 32907. SERVICES: A graveside service will be at 1:30 p.m.
Aug. 1 at Sebastian Cemetery, Sebastian, with the Rev. Ron Thomas
officiating. Arrangements are by Seawinds Funeral Home & Crematory,
Sebastian. A guest book may be signed at seawindsfh.com/obit.php.
CITY OF SEBASTUIN
CITY CLERK'S OFFICE 4 5 7 4
RECEIPT
~ '
~ ~ ~"~~~
l~
Name 1.
^ Cash
Date ~~ 3 ~' ~~ Check A I v ~"t~
No. Amount Paid
001001208001 Sales Tax
001501322900 Garage Sales
001501341920 CopieslBid Specs.
001501341910 LDCICode of Ordinances
001501 341930 Election Qualifying~FQees~
' " -1 ~ ~ ~~ (0.
601010343800 Cemetery Lots
~6-if ~~ps
LofMiche .Block .Unit
001501343805 ~ ~`'
Cemetery Fees ~~. ~
/' ~ ~ ~.
~`•' Total Palo t~U. ~
Initials
Wbito - Dept. of Origin • Yellow - Finance • Pink • Applicant
~~
~~~~ ~~
~~. ~~
~~ ~~
NCfME t}F PEt.IGN [5tJ0.1dEt
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.
~~~el(~ Iphi Iti
Name(s) '
~~ ( ~Q.YI ~./C~.n SfYe ~ ~ ~ Cf ~C~S t~"~ G~1 FC~ 3 Z ~i S ~S'
Address
Area Code & Phone Number
Name & Residence Address
if~Plther Than Purchaser
OFFICE USE ONLY
Receipt is acknowledged in the sum of:
1`C7 ~~~ . Gt~OI~ ~~6 ~ '~--J
on this. 2. ~ day of ~GZ-rt-u-Cc-1~
Cemetery Lot(s) and/or Niche(s).
Dollars ($ ~~- ao )
20 D 9 for the purchase of the following described
Unit ~ ,Block ~L ,Lot(s) Niche(s) / ~ ~/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
Vase and Ring for Niches (cost) ~, ~ D Interment
Temporary Marker Preparation & Installation
Signature of Purchaser
of Sebastian
The following documents were provided as Proof of
Residency:
/W O H
Circle One
Disinterment
TOTAL $ oZ ~ ~ 02. - O D
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