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Certificate No. 2218
CITYOFSEBASTIAN
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, Bilk 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,gEBASTIAN, FLORIDA
I Al Minner
City Manager
ATTEST:
Sally . Maio, MMC
City Clerk
Obituaries I Death Notices I Newspaper Obituaries I Online Obituaries I Newspaper D... Page 1 of 1
BARBARA JOAN JONES
Barbara Joan Jones, 58, died April 27, 2009, at Sebastian River Medical Center, Roseland.
She was born in Oswego, N.Y., and lived in Sebastian for nine years, coming from Boca
Raton. She was an administrative assistant in the health care industry. She was a
member of St. Sebastian Catholic Church, Sebastian. Survivors include her husband of 38
years, Arthur Jones of Sebastian; daughters, Lisa Licari of Greenacres and Andrea
Willocks of Vero Beach; mother, Theresa Metz of Oswego; brother, Nelson Metz III of
Oswego; sisters, Nancy Jean Ratigliano of Ballston Spa, N.Y., Margie Ravisi of Oswego
and Laurie DeLuca of Hardwick, N.J.; and four grandchildren. Memorial contributions may
be made to the Leukemia & Lymphoma Society, 4360 Northlake Blvd., #109, Palm Beach
Gardens, FL 33410. SERVICES: Visitation will be from 11 a.m. to 1 p.m. April 30 at the
Strunk Funeral Home, Sebastian. A Mass of Christian burial will be celebrated at 1 p.m.
April 30 at St. Sebastian Catholic Church, Sebastian. Burial will be in Sebastian Cemetery.
Published in the TC Palm on 4/29/2009
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E
FLORIDA DEPARTMENT OF
HEALT
A. (TYPE)
State of Florida, Department of Health, Vital Statistics
APPLICATION FOR BURIAL - TRANSIT PERMIT
1. Name of First
Middle Last
Date Month Day Year
Deceased
of
Barbara
Joan Jones
Death April 27 2009
2. Place of Death City, Town or Location
Name of (If neither, give street address)
County
Hosp. or
Indian River Sebastian
Inst. Sebastian
River Medical Center
3. Name of Medical
Address
Phone Number
Certifier Harish Sadhwani, D.
12920 U.S. #1
Medical Examiner lPhysician
Sebastian FL
772- 581 -2373
4. Name of Funeral Home/wectrm oral
Address
Fla. Lic. No. /Reg. No.
Phone No. (Area Code)
1623 N . Central Ave.
Establishment
trunk Funeral Home & Cremato
Sebastian, FL
1228
772 - 589 -1000
5. Check a. U The medical certification has been completed and signed. A completed certificate of death accompanies this
Appropriate application.
Box
b. Cynthia was contacted on 4/28/09
He /she verified that this death was from natural causes, that there was no accident nor other external cause of death,
and that Dr. Sadhwani will complete and sign the medical
certification of cause of death within 72 hours.
C. was contacted on He /she verified that
Medical Examiner, will complete and sign the
medi rtifiSKio,Af cause of death within 72 hours.
6. Funeral Director/ Si at F.E. No. /Reg. No. Date Signed
�c
Qifi Wr 44048 4/28109
B. I BURIAL - TRANSIT PERMIT
Permission is hereby granted to dispose of this body. Permit No. 1228 -09 -0203
A five (5) day extension of time for filing the death certificate (exclusive of weekends) has been requested and granted since the physician has
been contacted by the funeral director and will not be able to complete the medical certification of cause -of -death section of the death certificate within
72 hours.
[:]No extension of time for filing the death certificate has been requested.
Registrar or Date Date Certificate
SubregistrarSignature , . �. 0" Issued: 4/28/09 Dye: 5/2/09
C. AUTHORIZATION for CREMATION, DISSECTION, or BURIAL -AT -SEA
Approval Number: Date
Medical Examiner, , gave authorization by telephone to
Funeral Director /Direct Disposer. Date
The Medical Examiner's approval must be obtained before disposal by any of the above methods. A waiting period of 48 hours after death is
required for all cremations.
D. CEMETERY OR CREMATORY
Method of Disposition: Place of Disposition Sebastian Cemetery
BURIAL
CREMATION
Signature of Sexton
or Person -in- Charge
STORAGE Date of Disposition
OTHER (Specify)
This permit must be endorsed by the Sexton or person -in- charge (or by the Funeral Director /Direct Disposer when there is no Sexton) and returned
within 10 days to the local County Health Department in.the county where disposition occurred.
Distribution: white: Cemetery or Crematory
DH 326, 8/97 (Obsoletes all previous editions) Yellow: Funeral Director or Direct Disposer
(Stock Number: 5740 4)00 -0326 -2) Pink: Local Registrar ` P-r-
Sep 26 2008 2:45PM HP LRSERJE:T 3200 p,1
FUNERAL DIRECTOR'S REQUEST TO CITY OF SEBASTIAN
FOR BURIAL OPENING IN SEBASTIAN MUNICIPAL CEMETERY
SEBAST
11040 to PEUCN. ISLAND
Fol inforrnatior. cornact:
Ki Kelso - Cemetery Sexton
Se astian Municipal Cemetery
So,
(772) 589 -2545
STRUNK
FJtiERAL HOME:
ADDRESS:
PHONE #:
I City Clerk's office
iry Hal., 1225 Main Street
Sebastian, FL 32958
OlNG (772) 388 -8215 or 388.8214
Fax: (772) 589.5570
UN RAL HOME & CREMATE
162 No. Central Ave.
(heok One)
OPEN BURIAL LOT
OPEN CREMAINS LOT
OPEN COLUMBARIUM NICHE
BURIAL DATE AND SERVICE TIME
FOR DECEASED: Barbara J
i,4ume
:`DAME AND SIGNATURE OF LOT OW
( "dust provide proper documentation of
Name
I certify tnat I have determined the ownr
administrative fees have been paid and
38 Block 11 Unit 4
.r,Block Unit
he Block -Unit -
VV
pril 30, 2009 1 P.M.
Jones
ER OR REPRESENTATIVE:
wnership)
Signat -re V D5te
ship of the above described si ±e Ihat all site fees and
authorize opening of sgme
NA -ME AND IGNATJRE OF LICENSE? FUME D TOR.
i
warn to
Cemetery Sexton Cerlffication Date
--- -- -----------_---------------------------------- __- _----- __- _----
I certify that I have checked the ovinersr p inforn ation by viewing the owner's deed and confirming
with Clerk's office and that all fees have een paid
Cemetery Sexton
This form to be provided to Clerk's Off
Date
by Sexton for permanert record upon compieaon.
i�
Name
Unit
Block
Lot
Date of Mark -out
Date of Burial Time
Name of Funeral Home
Authorized by
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