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HOME OF PELICAN ISLAND
Certificate # 1975
MY 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:
William H. or Jean Dinwoodie 1322 Shoreline Circle, Sebastian, Fl 32958
(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 plots:
Unit_. 3_ Block _COL_ Niche_22Ds_
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 28th day of July, 2004.
FLORIDA
City Manager
A. Maio, CMC
City Clerk
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Name t '�'2
�~
Unit 3
Block
Lot 00
Date of Mark -out
// 1 3 a
Date of Burial ` Time
Name of. Funeral Home
Authorized by
CITY OF SEBASTIAN 10098
ADMINISTRATIVE SERVICES RECEIPT
Name- - iw lx. 1 0Cash
Date �' a r,fieRI�d Check
L) Credit
Amount Paid
001001 208001 Sales Tax
001001 220000 Security Deposit
001501 362100 Taxable Rent
001501 362150 Non -Taxable Rent
450010 369900 Airport Badge
001001218010 CobraServe
001501 354100 Code Enforcement Fines
001501 347557 Community Center Revenue
001501341920 Copies
001501 351140 Parking Citation
001501 342100 Police Security Services
001501 329200 Site Plan Review
001501 329300 Subdivision/Plat Review
001501 329100 Zoning Fees
On f 'Sb t 34wcs- 4 co
�rJ rr COL 'AAM
WVIZV Total Pant`_4_- a
iti Is
Security Dep Held - Amount $ Check #
White - Dept. of Origin - Yellow - Admin. Svcs. - Pink - Applicant
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SEBASTMN
HOME OF PELICAN ISLAND
1225 Main Street, Sebastian, F132958
Telephone (772) 589 -5330 — Fax (772) 589 -5570
July 28, 2004
Mr. and Mrs. William H. Dinwoodie
1322 Shoreline Circle
Sebastian, Fl 32958
Dear Mr. and Mrs. Dinwoodie:
Enclosed is City of Sebastian Certificate 1975 for the purchase of Cemetery Niche 22Ds,
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.
Since ,
Sally A. M o, CMC
City Clerk
SAM:ar
enclosure
CITY OF SEBASTIAN
CITY CLERK'S OFFICE
3046
No. f / Amount Paid
001001208001 Sales Tax
001501322900 Garage Sales
001501341920 CopiewSid Specs.
001501341910 LDUCode of Ordinances
001501341930 Election Qualifying Fees
601010 343800 Cemetery Lots
LotMiche . Block . Unit
001501343805 Fees
Total Pais'
• itiale
White - Dept. of Origin • Yellow - Finance • Pink - Applicant
SE]1AS,T%N q .�
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HOME Of I PELICAN ISLAND
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 I
Ge/ / // 0 i^ tip / I7 LIE &d
Name(s)103 a oZ �l'!a r /1 0 C'C
Area Code & Phone Number
Residence Address of Intended Occupant if Other Than Purchaser
Office Use Only
Receipt is acknowledged in the sum of:
Dollars ($ o • Off)
on this " day of , 20 a for the purchase of the following
described Cemetery Lot(s) di o I he(s).
Unit I Block Odl• , Lot(s) Niche(s) V:74/-.Z5'
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
Signature of Purchaser of Sebastian
W O H
Circle One
Disinterment
Service fees are to be paid at time of need only
I: \W W- DATA \Ms - Cemetery\RECEIPT.doc
CITY OF SEBASTIAN O
CITY CLERK'S OFFICE
RECEIPT
Name 'ltL ❑ Cash
Date eck #
No. Amount Paid
001001208001 Sales Tax
001501322900 Garage Sales
001501341920 CopieslBkl Specs.
001501341910 LDClCode of Ordinances
001501341930 Eldon QuaFfyirrg Fees
'801010 343800 Cemetery Lots �r
LotlNkhe� Bak S6 Unit
001501343805 Cemetery Fees
y
Total Paw
Initials
White - Dept. of Origin • Yellow - Finance • Pink - Applicant