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Certificate No. 2207
Certificate of Interment Rights
IN ACCORDANCE with provisions of the Code of Ordinances of the City of
Sebastian, it is hereby certified that:
Edward G. Brown Jr &
Rechelle C. Brown 619 Cavern Terrace, 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 lots:
Unit 4, Blk 10, Lots 25 & 26
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 11th day of February, 2009.
OF BASTIAN, FLORIDA ATTEST; -
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AI Minner Sally A aio, MMC
City Manager ity Clerk
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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.
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Name(s)
Address
Area Code & Phone Number
Name & Residence Address of Intended Occupant if Other Than Purchaser
OFFICE USE ONLY
Receipt is acknowledged in the sum of:
~V~ l~_~lA ~ (,~~ Dollars ($024~~ - ~~ ) .
on this. ~ day of , 20~ for the purchase of the following described
Cemetery Lot(s) and/or Niche(s).
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Unit ~, Block ___~Q__, Lot(s) c~JC ~i a ~ 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
Vase and Ring for Niches (cost)
Interment
Temporary Marker Preparation & Installation
/W O H
Circle One
Disinterment
TOTAL $ c~-0~) . OCR
Signature of Purchaser Sebastian
The following documents were provided as Proof of
Residency:
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1:1W W-DATAUNs-Cemetery\RECEIPT.doc I ~d
CRY OF SEBASTIAN
CRY CLERK'S OFFICE /, ~ C i
RECEIPT ~ 4 U 1
Neme ^ Cash
Date ~' //{~q CheckO~~
No. Amount Paid
001001208001 Sales Tax
001501322900 Garage Sales
001501341920 Copiesl6id Specs.
001501341910 LDC/Code of Ordinances
001501341930 Ekertion (qualifying Fees
601010343800 Cemetery Lots ~ ~"
LofMiche~°-1=p'~'~'~ ~ Unit
001501343805 Cemetery Fees
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Total Paid
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