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Unit IC-11,
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15-
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Certificate # 1929
CITY OF SEBASTIAN
Certificate of Interment Rights
IN ACCORDANCE with provisions of the Code of Ordinances of the City of Sebastian,
it is hereby certified that:
Stephen & Karen DiTrapano 942 Chelsea Ave.,_ Sebastian, Fl 32958
(name) (address)
(name) (address)
in and for consideration of the sum of $1,350.00 , has purchased and is entitled to full
interment rights in the Sebastian Municipal Cemetery for the following plot:
Unit 3 , Block COL , Lot(s) 15 D S
of the Sebastian Municipal Cemetery,
as maintained on file in the records of the City Clerk
for use in accordance with the conditions, ordinances, resolutions, rules and regulations
prescribed therefore by the City of Sebastian.
CONVEYED THIS 21 s tday of November , 2003.
ITY OF SEBASTIAN, FLORIDA A T:
ence o e Sally aio, CMC
City Manager City Clerk
'I
OY OF
_ O
HOME OF PELICAN ISLAND
November 24, 2003
Stephen & Karen DiTrapano
942 Chelsea Avenue
Sebastian, Fl 32958
Dear Mr. & Mrs. DiTrapano:
Enclosed is City of Sebastian Certificate Number 1929 for the purchase of Cemetery Niche
15DS, Columbarium, Unit 3. Also enclosed is a copy of your receipt and the Rules and
Regulations governing the Sebastian Municipal Cemetery.
If you have any questions, please contact our office.
Smc y,
Sally A. 'o, CMC
City Clerk
SAM:ar
enclosure
PLEASE PRINT
DECEASED 6
NAME:
(First) (Middle) (Lag)
DATE OF BIRTH:_- _- d/�L
/ 55
(Month) (Day) (Year)
DATE OF DEATH:
(MOB) (Day) (Year)
SIGNA
PRINT
SIGMA'
�Op�
DATE: /y O
FOR OFFICE USE ONLY
Unit 3
Doubles / South
COLUMBERIUM:
(South)
lICH
NUMBER:
c
OA
2::>
PLEASE PRINT
DECEASED '')) !1,`
NAME: C f� m . �J P �p flip
(First) (Middle) (Last)
DATE OF BIRTH: F^ LQ 5�� S
(Month) (Day) (Year)
DATE OF DEATH:
(Month) (Day) (Year)
SIGNATURE:
PRINT
SIGNA
Unit 3
Doubles / South
COLUMBERHJM:
NIGH
NUMBER:
X01 X03
FOR OFFICE USE ONLY
(South)
aBr of
SEBAS,nAN 7-1
HOME Of PELICAN BLAND
City of Sebastian Municipal Cemetery
Purchase Receipt
To enable the City of Sebastian to determine the correct rate, and in accordance with cemetery
rate regulations, residence of purchaser or person for whom lot is intended for interment must be
provided at time of urchase
•�: �ikIPxn 0
1C krer, m, *�):Trux» o
Name(s)
9 ya C he) se ;L+ �. v e • Seb$s�; � �1. �1 gS8
Address
71'�- 38'8'- od 6-17
Area Code & Phone Number
Residence Address of Intended Occupant if Other Than Purchaser
Office Use Only
Receipt is acknowledged in the sum of:
on this day of
describe Cemetery Lots nd /or Niches;
Dollars
for the purchase of the following
Uni,,?_, Bloc i , Lot(s) ,/ � 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 &
Vase and Ring for Niches (cost)
of Purchaser
City of Sebastian
TOT
Service fees are to be paid at time of need only
I:1W W- DATA1Ms- Cemetery\RECEIPT.doc
W O H
Circle One
.icy 0. d-d
CITY OF SEBASTIAN
CITY CLERK'S IPOFFICE 2324
Date
Z-,-' D Check*
No.
Amount Paid
001001208001
Sales Tax
001501322900
Garage Sales
001501341920
Copies/Bkl Specs.
001501341910
LDGCode of Ordinances
001501341930
Election Qualifying Fees
601010 343800
Cemetery Lots
r%�•D�'
Lot/Niche /�. BIo�'o L . Un�
001501343805
Cemetery Fees
To Paid 4l
Initials
W ite - Dept. of Origin • Yellow - Finance • Pink • Applicant