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Home My WebLink About3-COL-47DnBName �,�h�,�1l4►2�� ,,�55D �/1,,,✓S� i 50 Ale. 01 Block Gt�� Lot Date of Mark -out 11y //Y Date of Burial &,_W l f? Time Name of Funeral Home C 'IE Authorized by Name Unit Block Z b A- Lot- /V I Date of Mark -out Date of Burials /� /J�/� Time Name of Funeral Home C Authorized by � - MY OF HOME OF PELICAN ISLAND Certificate No. 2424 CITY, i F SEBASTIAN Certificate of Interment Rights IN ACCORDANCE with provisions of the Code of Ordinances of the City of Sebastian, it is hereby certified that: John A. Russo, John C. Russo, & Lisa Marie Eastwood +603 Mallow Scrub Way Sebastian, FL 32958 In and for consideration of the sum of $2,000 is entitled to full interment rights in the Sebastian Municipal Cemetery for the following niche: Unit 3, Columbarium, Niche 47dnb 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 14th day of July, 2014. CITY OF SEBASTIAN, FLORIDA r , Joseph F. Griffi City Manager ATTEST: Sally A.,Maio, MMC City Cl6rk In Memory of Rosemaria Russo November 26, 1946 - April 12, 2009 Rosemaria Russo, 62 of Sebastian, Fl passed away Sunday, April 12, 2009 at VNA Hospice House in Vero Beach, fl. She was born November 26, 1946 in Brooklyn, NY and was a resident of Sebastian for 7 years, coming from Long Island, NY. Mrs. Russo was a homemaker and was a member and Eucharist Minister of St. Sebastian Catholic Church and belonged to the St. Helen's Prayer Group. Survivors include her husband of 41 years, John A. Russo of Sebastian, FL; daughter Lisa Marie Eastwood of West Islip, NY; son John C. Russo of Sebastian, FL and two grandchildren. Total Paid�� Initials White - Dept. of Origin • Yellow - Finance • Pink - Applicant CITY OF SEBASTIAN CITY CLERK'S OFFICE RECEIPT 489,3 /'r o E--u-sso Name_I i C Cash Date I Check# No. Amount Paid 001001 208001 Sales Tax 001501322900 Garage Sales 001501 341920 Copies/Bid Specs. 001501 341910 LDC1Code of Ordinances 001501 341930 Election Qualifying Fees 601010 343800 Cemetery Lots (� 47dnh LoVNiche Block Unit - re tt f h f m L n fi 001501343805 Cemetery Fees C , (1 • 0Q, Total Paid�� Initials White - Dept. of Origin • Yellow - Finance • Pink - Applicant arYOF SEBAST1 HOME OF PELICAN ISLAND 1225 MAIN STREET • SEBASTIAN, FL 32958 (772) 589 -5330 July 1, 2014 This is to be considered proof of receipt of Certificate No. 2210 issued to John A. Russo for interment rights to Unit 3, Col, Niche 47dnb. A refund check for the interment rights is currently being processed and will be mailed to him next week. '�I iu-' 6 -Q1' c!� . Jhanette Williams Deputy City Clerk ,1� 1 cue _Zx ju - 50.d0 1 7 a 1 t� "eat-, e-q St CITY OF SEBASTIAN CHECK REQUEST Accounting Use Only Input Date Fiscal Period Document # Entered By Document Amount # of Lines Total HC Hash Due Date To Be Completed By Department 7/11/2014 Single Check YIN Vendor Number IN TC Reference Organization Code Object Code Project Code Amount 601011 534959 $1,900.00 001501 343805 ($50.00) Description Number of Lines Amount Disinterment of wife's cremains Unit 3, Col, Niche 47dnb Purchase price $2000. minus 5% admin fee; minus 50.00 disinterment fee ISSUE CHECK TO $1,850.00 NAME John A. Russo ADDRESS 603 Mallow Scrub Way CITY Sebastian STATE FL ZIP CODE 32958 DRAW CHECK WM SEE BELOW APPROVED B DATE — BUDGET APP 0 MAIL ATTACHED DOCUMENATION (Except for remit slips, requesting department should attach a copy of documentation along with the original) OTHER INSTRUCTIONS Please give copy of check to Jeanette for file Certificate No. 2210 IN ACCORDANCE with provisions o Code inances on City of Sebastian, it is hereby certified that: y John A. Russo, I 865 P . In and for con ratid rights in the Se 6 ian i for use in accorda regulations prescrib rson Aven the sum of $i X ,cipal Cemete FL .00 isntitled to full interment the following niche: Un ol, Niq __ � 7dnb Sebast LWipal Cemetery. ,on file in the records of the City Clerk e conditions, ordinances, resolutions, rules and pre by the City of Sebastian. CONVEYED THIS 3rd day of April, 2009. CITY Off EBASTIAN, FLORIDA Al Minner City Manager ATTEST: — 3--&" e� Sally . Maio, MMC City Ciqpk C t_ ,'" �� > F/ Name - Unit Block AJ h ASV Lot Date of Mark -out Date of Burial Time Name of Funeral Home ! Authorized by SEAWINDS CREMATORY Sebastian, Florida (4 735 Fleming Street • Sebastian, Florida 32958 www.seawindsfh.com (772) 589 -1933 We hereby certify that these are the remains of ROSEMARIA RUSSO The remains were received from SEAWINDS FUNERAL HOME Cremation Permit No. 09- 2617 -092 Issued at INDIAN RIVER Date of Death APRIL 12, 2009 APRIL 16, 2009 By SAM COBURN Date of Cremation Cremator off OF SIESA 1 -2 A HOME 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. h uS,5a . -o�n- c. cis LIS2 M&r-i DECEASED NAME: O (First) DATE OF BIRTH: DATE OF DEATH: SIGNATURE: PLEASE PRINT 0 - a (Middle) (Last) U'S c, c- U J (Month) (Day) (Year) (Month) (Day) (Year) PRINT /�—' SIGNATU I/ ® ,4 DATE: FOR OFFICE USE ONLY Unit 3 Double / North / B COLUMBERIUM: (tiuuth) N1CH NUMBER. 7-vsJv DECEASED NAME: PLEASE PRINT (First) (Middle) 611 0 (Last) DATE OF BIRTH: �� + 6� (Month) (Day) (yam) DATE OF DEATH: (Month) (Day) (Year) SIGNATURE: PRINT f ---- SIGNATU V,01, DATE: 3 - 1 3 - 0 % FOR OFFICE USE ONLY Unit 3 Double / North / B COLUMBERRM: (Souls)) NICH NUMBER. J, W Total Paid 0 Initials White - Dept. of Origin • Yellow - Finance • Pink • Applicant CITY OF SEBASTIAN CITY CLERK'S OFFICE RECEIPT 4233 Name 9US50 3--13 - COQ ❑ Cash #4a Date No. Amount Paid 001001208001 Sales Tax 001501322900 Garage Sales 001501341920 Copies/Bid Specs. 001501341910 LDCICode of Ordinances 001501341930 Election Qualifying Fees d�t� 601010 343800 Cemetery Lots �,, ,J C.LJ, LoVNd h U Block Unit 15-01-100 001501343805 Cemetery Fees e + ri h AC2p0 J, W Total Paid 0 Initials White - Dept. of Origin • Yellow - Finance • Pink • Applicant FUNERAL DIRECTOR'S REQUEST TO CITY OF SEBASTIAN FOR BURIAL OPENING IN SEBASTIAN MUNICIPAL CEMETERY ma MAST For information contact: Kip Kelso - Cemetery Sexton Sebastian Municipal Cemetery (772) 589 -2545 City Clerk's Office City Hall, 1225 Main Street Sebastian, FL 32958 Office (772) 388 -8215 or 388-8214 Fax: (772) 589 -5570 FUNERAL HOME: ZAW 1 a QS ADDRESS: '15S F1 6-eni m -S PHONE #: I"? Z - 951 - Lq (Check One) OPEN BURIAL LOT Lot Block Unit QPEN CREMAINS LOT Lot Block Unit yy OPEN COLUMBARCUM NICHE Niched Block Unit 1_ N S E W BURIAL DATE AND SERVICE TIME: Z'• 30 P 14 • I(# • o FOR DECEASED: "R®S e ffiftti.A 1y RuSS� Name NAME AND SIGNATURE OF LOT OWNER OR REPRESENTATIVE: (Must provide proper documentation of ownership) Name Si. re Date I certify that 1 have determined the ownershiW the above described site, that all site fees and administrative fees have been paid and authorize opening of same. NAME AND SIGNATURE OF LICENSED FUNERA (RECTOR: S,v. Cod ��, 4-)4-05 Name S g tore I 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: Cem tery exton 04te This form to be provided to Clerk's Office by Sexton for permanent record upon completion.