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HOME OF PELICAN ISLAND
Certificate No. 2205
C
UTY OF SSTIANI
Certificate of Interment Rights
IN ACCORDANCE with provisions of the Code of Ordinances of the City of
Sebastian, it is hereby certified that:
Zapopan Rivera 80 N. Magnolia Street, Fellsmere, Fl. 32948
(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 lot:
Unit 4, Blk 11, Lot 7
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 30th day of January, 2009.
EBASTIAN, FLORIDA
Al Minner
City Manager
ATT T:
� ,j r`
Sall o. Maio, MMC
City Clerk
Name
Unit
Block
Lot
Date of Mark -out
Date of Burial / f �% Time � J yz' + ' ° C
Name of Funeral Home
Authorized by
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Obituaries I Death Notices I Newspaper Obituaries I Online Obituaries I Newspaper D... Page 1 of 1
EULALIO RIVERA
Eulalio Rivera, 76, died Jan, 27, 2009, at Indian River Medical Center, Vero Beach. He
was born in Mexico and lived in Fellsmere for 35 years, coming from Bartow. He was the
owner of Rivera's Lawn Service. Survivors include his wife of 58 years, Zapopan Rivera of
Fellsmere; sons, Alberto Rivera of Boaz, Ala., Eulalio Rivera Jr. of Vero Beach and Gerardo
Rivera of Fellsmere; daughters, San]uana Rivera, Lydia Villalobos and Rebeca Garcia, all
of Vero Beach, and Ana Maria Andrade, Maria Del Rosario Rivera and Hermenia Rivera, all
of Fellsmere; sister, Adela Rivera of Mexico; brother, Jose Rivera of Mexico; 32
grandchildren; and 33 great - grandchildren. He was preceded in death by his son, Adrian
Rivera. SERVICES: Visitation was Jan. 30 at Seawinds Funeral Home Chapel in Sebastian.
A service will be at 11:30 a.m. Jan. 31 at St. Sebastian Catholic Church in Sebastian.
Burial will follow in Sebastian Cemetery. Arrangements are by Seawinds Funeral Home
and Crematory. A guest book may be signed at seawindsfh.com /obit.php.
Published in the TC Palm on 1/31/2009
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FUNERAL DIRECTOR'S REQUEST TO CITY OF SEBASTIAN
FOR BURIAL OPENING IN SEBASTIAN MUNICIPAL CEMETERY
S
HOMf OF PELICAN KlMlD
For information contact:
Kip Kelso - Cemetery Sexton
Sebastian Municipal Cemetery
(772) 589 -2545
FUNERAL HOME:
ADDRESS:
PHONE #:
City Clerk's Office
City Hall, 1225 Main Street
Sebastian, FL 32958
Office (772) 388 -8215 or 388 -8214
Fax: (772) 589 -5570
SEA Wi0nS
'13S F
.S13q -i'C!�
(Check One)
OPEN BURIAL LOT
OPEN CREMAINS LOT
OPEN COLUMBARIUM NICHE
BURIAL DATE AND SERVICE TIME:
Lot -7 Block i 1 Unit I'
Lot Block Unit
Niche Block Unit
N S E W
FOR DECEASED: JC—: 44 j/3110 /K �
Name
NAME AND SIGNATURE OF LOT OWNER OR REPRESENTATIVE:
(Must provide proper documentation of ownership) R
UA-
Name S gnature 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.
NAME SIGNATURE OF LICENSED FUNERAL ECTOR:
,A Lot Lj 1-3,0.01
e 4igr9ture 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
Date
This form to be provided to Clerk's Office by Sexton for permanent record upon completion.
SIAIEMENT 123396
Date 0'
TO
Ck,
TERMS
?>2
IN ACCOUNT WITH
FLORIDA DEPARTMENT OF
HEALT
State of Florida, Department of Health, Vital Statistics
APPLICATION FOR BURIAL - TRANSIT PERMIT
t. Name of First
Middle
Last
Date
Month Day Year
Deceased EULALIO
RIVERA
of
01 27 2009
Death
2. Place of Death City, Town or Location
Name of (If neither, give street address)
County INDIAN RIVER
VERO BEACH
Hosp.or INDIAN RIVER MEDICAL CENTER
Inst.
3. Name of Medical
Address
Phone Number
Certifier DEREK K. PAUL, MD
1850
37TH STREET
MMedical Examiner F71Ph
ysician
VERO
BEACH, FLORIDA 32960
569 -5660
4. Name of Funeral Home/Direct Disposal
Address
Fla. Lic. No. /Reg. No.
Phone No. (Area Code)
Establishment
735 S Y-LE- ING STREET
SEAWINDS FUNERAL HOME
SEBASTIAN,
FLORIDA 32958
2617
772 -•589 -1933
5. Check a. U I ne medical cenmcauon nas been cornpteteu anu siyncu.
Appropriate application.
Box
b. ® OXXXRXRR DR, PAUL was contacted on 01/29/09
He /she verified that this death was from natural causes, that there was no accident nor other external cause of death,
and that HE will complete and sign the medical
certification of cause of death within 72 hours.
C. was contacted on He /she verified that
, Medical Examiner, will complete and sign the
medical certification of cause of th within 72 hours.
6. Funeral Director/ Signature F.E. No. /Reg. No. Date Signed
Direct Disposer FO 44126 01/29/09
B. BURIAL - TRANSIT PERMIT
Permission is hereby granted to dispose of this body. Permit No. 09- °2617 -x033
Qk five (5) day extension of time for filing the death certificate (exclusive of weekends) has been requested and granted since the physician has
been contacted by the funeral director and will noA be able to complete the medical certification of cause -of -death section of the death certificate within
72 hours.
[:]No extension of time for filing the deat certifi t has en re uested.
Registrar or Date Date Certificate
Subregistrar Signature Issued: 01129!09 Due: 02/10/09
C.
Approval Number:
AUTHORIZATION for CREMATION, DISSECTION, or BURIAL- AT-SEA
Date
Medical Examiner, , gave authorization by telephone to
Funeral Director /Direct Disposer. Date
The Medical Examiner's approval must be obtained before disposal by any of the above methods. A waiting period of 48 hours after death is
required for all cremations.
Method of Disposition:
® BURIAL
CREMATION
Signature of Sexton t
or Person -in- Charge J)
STORAGE
OTHER (Specify)
CEMETERY OR CREMATORY
Place of Disposition
SEBASTIAN CEMETERY
Date of Disposition l / 3 / /b !--
V
This permit must be endorsed by the Sexton or person -in- charge (or by the Funeral Director /Direct Disposer when there is no Sexton) and returned
within 10 days to the local County Health Department in the county where disposition occurred.
Distribution: white: Cemetery or Crematory
DH 326, 8/97 (Obsoleles all previous editions)
Yellow: Funeral D� ac or a Direct Dispo °ser
(Stock Number. 5740.(00 -0326 -2) Pink: Local Registrar %I �