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Certificate No. 2217
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Certificate of Interment Rights
IN ACCORDANCE with provisions of the Code of Ordinances of the City of
Sebastian, it is hereby certified that:
Thomas J. Colletti, Jr. 13015 75th Court, Sebastian, FL 32958
(name) (address)
In and for consideration of the sum of $6,000.00 is entitled to full interment
rights in the Sebastian Municipal Cemetery for the following lots:
Unit 4, Blk 11, Lots 14, 15, & 16
of the Sebastian Municipal Cemetery,
as maintained on file in the records of the City Clerk
for use in accordance with the conditions, ordinances, resolutions, rules and
regulations prescribed therefore by the City of Sebastian.
CONVEYED THIS 25th day of April, 2009.
CITY 0 ~~EBASTIAN, FLORIDA
4 AI Minner
City Manager
ATTEST:
-,
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Sally ~, aio, MMC
City Clerk
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Ht3ME QF PELICAN 15LANC?
City of Sebastian Municipal Cemetery Purchase Receipt
To enable the City of Sebastian to determine the correct rate, and in accordance with cemetery rate
'regulations, proof of City residency of purchaser or person for whom lot is intended for interment must
be provided at time of purchase.
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Name(s)
~ ~D ~ 5 7~'~' Courf ~~bQsfic~r~ F"~ 3zg5~
Address
(7 ~z) ~1~3~ 8vZ3
Area Code & Phone Number
Name & Residence Address of Intended Occupant if Other Than Purchaser
OFFICE USE ONLY
Receipt is acknowledged in the sum of:
lars ($ ~~a o0
on this. 2 5 ~` day of ~b r ~ ( , 20 ~ ~ for the purchase of the following described
Cemetery Lot(s) and/or Niche(s).
Unit ~T ,Block ~ ~ ,Lot(s) I ~/, l5+((o 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,
Signature of Purchaser
/W O H
Circle One
Disinterment
TOTAL $ ODC~. DD
W'
ty of Sebastian
The following documents were provided as Proof of
Residency:
Interment
I:\WW-DATA\Ms-CemeterylRECEIPT.doc
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