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St DIAN
HOME OF KLICAN (STAND
cop �
Certificate # 1941
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:
Robert N. & Julieann Farrell 349 Fordham Street, Sebastian, FI 32958
(name) (address)
in and for consideration of the sum of $1,350.00 has purchased and is entitled to full
interment rights in the Sebastian Municipal Cemetery for the following plot:
Unit — 3-1, Block _COL , Lot(s)_24Ds _
Of the Sebastian Municipal Cemetery,
as maintained on file in the records of the City Clerk
for use in accordance with the conditions, ordinances, resolutions, rules and regulations
prescribed therefore by the City of Sebastian.
CONVEYED THIS 20th day of January, 2004.
Cn OF SEB TIAN, FLORIDA ATTEST:
errenc oore Sally . Maio, C C
City Manager City Clerk
O
aly or
SETA
HOME OF PELICAN ISLAND
City of Sebastian Municipal Cemetery
Purchase Receipt
To enable the City of Sebastian to determine the correct rate, and in accordance with cemetery
rate regulations, residence of purchaser or person for whom lot is intended for interment must be
provided at time of purchase
Name(s)
�.Cm eS�i9fs -� �% - c,E.�3.�JT /t�.c ] , �L 3 Z`T T�
Address
7-2 2 -
Area Code & Phone Number
Residence Address of Intended Occupant if Other Than Purchaser
Office Use Only
is acknowledged in the sum of:
lags ($
on this _day of , 200 for the purchase of the following
described Cemetery Lot( and /or Nl he(s).
Unit_, Block (2o 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) . O D Interment
Signature of Purchaser Ity of Sebastian
Disinterment
Service fees are to be paid at time of need only
I: \W W- DATA\Ms- Cemetery\RECEI PT.doc
W O H
Circle One
$ 1,?498 r 00
January 19, 2004
Robert N. and Julieann Farrell
349 Fordham Street
Sebastian, Fl 32958
Dear Mr. & Mrs. Farrell:
Enclosed is City of Sebastian Certificate Number 1941 for the purchase of Niche Number 24Ds,
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.
Sm ,
Sally A. M ' , CMC
City Clerk
SAM:ar
enclosure
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CITY OF SEBASTIAN
CITY CLERK'S OFFICE /,
RECEIPT `¢
Name ❑ Cash
Date 6K kt«�OT
No. Amount Paid
001001208001 Sales Tax
001501322900
Garage Sales
001501341920
Copies/Bld Specs.
001501341910
LDC /Code of Ordinances
001501341930
Ek*n Qualifying Fees
601010 343800
Cemetery Lots
LotMicham& Bbd — Unit
001501343805
Ceme F
' a
Total Paid
Initials
White - Dept. of Origin • ►Nlow - Finance • Pink • Applicant