HomeMy WebLinkAbout4-11-37Certificate No. 2218
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:
Mr. Arthur Jones 1380 Coverbrook Lane, Sebastian, FL 32958
(name) (address)
In and for consideration of the sum of $2,000.00 is entitled to full interment
rights in the Sebastian Municipal Cemetery for the following lots:
Unit 4, Blk 11, Lots 37 & 38
of the Sebastian Municipal Cemetery,
as maintained on file in the records of the City Clerk
for use in accordance with the conditions, ordinances, resolutions, rules and
regulations prescribed therefore by the City of Sebastian.
CONVEYED THIS 29th day of April, 2009.
OF ,SEBASTIAN, FLORIDA
Al Minner
f City Manager
ATTEST:
Sally /K Maio, MMC
City Clerk
CITY Of
LIM
HOME of PELICAN ISLAND
City of Sebastian Municipal Cemetery Purchase Receipt
To enable the City of Sebastian to determine the correct rate, and in accordance with cemetery rate
regulations, proof of City residency of purchaser or person for whom lot is intended for interment must
be provided at time of purchase.
IIV+h u. r Fo n es
Name(s)
1396 Co ve rbroo k Let.n e- as t+`ah rL 32-q 5(Y
Address
Area -Code & Phone Number
Name & Residence Address of Intended Occupant if Other Than Purchaser
OFFICE USE ONLY
Receipt is acknowledged in the sum of:
MO
Dollars ($ Q-000• Da )
on this ck �� day of r (� , 20 Dal for the purchase of the following described
Cemetery Lot(s) and /or Niche(s).
Unit `t' , Block 1 I , Lot(s) 3 � + 3.9_ 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 & Closing
Vase and Ring for Niches (cost)
Temporary Marker Preparation & Installation,
Interment
150.0
/W 0 H
Circle One
Disinterment
TOTAL $ , -1 5 0 . 110
Signature of Purchaser /qty of Sebastian
The following documents were provided as Proof of
Residency:
I: \WW- DATA \Ms - Cemetery\RECEIPT.doc I and
CITY OF SEBASTIAN
CITY CLERK'S OFFICE
4244
RECEIPT
Name _/q�h
a-r y C- r) e..s
❑ Cash
zz 1'�
Check #�
No.
Amount Paid
001001208001
Sales Tax
001501322900
Garage Sales
001501341920
'Copies/Bid Specs.
001501341910
LDCICode of Ordinances
001501341930
Election Qualifying Fees
601010 343800
Cemetery Lots
Lo fiche _) 6 , BW '
//��
-2"'100 00
Unit 14
001501 343805
Cemetery Fees
{
l ✓�• �O
Total Paid. 2 o0
.
Initials
White - Dept. of Origin • Yellow - Finance
• Pink • Applicant