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3-COL-39Sn
MY OF HOME OF PELICAN ISLAND Certificate No. 2222 Certificate of Interment Rights IN ACCORDANCE with provisions of the Code of Ordinances of the City of Sebastian, it is hereby certified that: Kathryn Maynard 4321 County Road #4, Montour Falls, NY 14865 (name) (address) In and for consideration of the sum of $2,400.00 is entitled to full interment rights in the Sebastian Municipal Cemetery for the following niche: Unit 3, COL, Niche 39SN 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 2nd day of June, 2009. BASTIAN, FLORIDA Al Minner City Manager ATTE Sally A Maio, MMC City Clerk Name Unit Block -i < Lot Date of Mark-out Time Date of Burial cr Name of Funeral Home Authorized by ic 50955025 ALL COUNTY FUNERAL ALL COUNTY FUNERAL Home & Crematory Home & Crematory Treasure Coast Chapel Palm Beach Chapel 1010 NW Federal Hwy. 1107 Lake Avenue Stuart, FL 34994 Lake Worth, FL 33460 We hereby certify that these are the cremated remains of: VIRIMINIA r19%w1hw E1114WHIP111 Cremaltion Permit No. 2340-955025 Issued at Indian Rivai Pate Death May 29, 2009 Z ttin No. 0942626 ate of Cremation —03 gy wo Lag &tee Cremator Obituaries I Death Notices I Newspaper Obituaries I Online Obituaries I Newspaper Death Notices I Onli... Page 1 of 1 Yiew[Sign.Guest Boak VIRGINIA D. (DOWNS) FISCHER Virginia D. Downs Fischer Virginia D. Downs Fischer, of Vero Beach, Florida passed away quietly on May 29, 2009. She was 86 years old. Virginia was the eldest of seven children; Helen Juiffre of North Carolina; Shirley Robinson (of Ohio, deceased); Jeanne Sheibler of Long Island NY; Alfred Downs of New Jersey; Robert Downs of Long Island NY; and Caroline Vernet of Long Island, NY. She is remembered as "Aunt Ginny" by her nieces and nephews. Ginny was the mother of five children: Mrs. Sandra Schemmerlin g (Colorado); Ray Fischer (Palm Bay, Fla.); Terrance "Terry" Fischer (Cocoa, Florida, deceased in January 2007); Ms. Kathryn Maynard (Grant Fla.); and Ms. Diane Drake (Vermont). Ginny was survived by 12 grandchildren: Eric and Gary Shemmerling; Ray and Rick Fischer; Terry, Jr., Chris, and Bob Fischer; William Shaffer, Jr. and Sean Maynard ; and Joe, Jason and Jessica Drake. In addition, she was fortunate to have been the great- grandmother of 23 children. A private service was held was held by immediate family. Published in the TC Palm on 6/7/2009 Today's TCPalm obituaries and death, notices Questions about obituaries and death notices or Guest Books? Contact_Legacy4om • Terms of us.e.. Powered by Legyacy.Ct3m obituaries nationwide Back http:// www .legacy.com/tcpalm/Obituaries. asp? Page= LifeStoryPrint &PersonlD =l28080321 6/12/2009 CRY OF L TIANI HOME OF PELICAN ISLAND 1225 Main Street Sebastian, FL 32958 (772) 589 -5330 Phone (772) 589 -5570 Fax June 4, 2009 Ms. Kathryn Maynard 4321 County Road #4 Montour Falls, NY 14865 RE. • Interment Rights to Unit 3, Columbarium, Niche 395N Sebastian Cemetery Dear Ms. Maynard: Enclosed is City of Sebastian Certificate 2222 entitling you to full interment rights in Unit 3, Col., Niche 39SN. Also enclosed is a copy of the Rules and Regulations governing the Sebastian Municipal Cemetery. If you have any questions, please contact our office. Sincerely, Sally A. City Clerk SAM:dwc enclosures UIY Of U ISIAN ST o 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. Name(s 18�5� Area Code & Phone Number ^. /- / / - Name & Residence Address of Intended Occupant if Other Than Pu OFFICE USE ONLY Receipt is acknowledged in the sum of: Dollars ($ c� Q 303 —Wg—` 95 on this day of 9200 1 for the purchase of the following described Cemetery Lot(s) and /or Nich ). Unit , Block _ , Lot(s) �---� Niche(s) f&rI 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: j c Gh Corner Markers (set of 4 - $20) Opening & Closing I J� O H Circle One Vase and Ring for Niches (cost) �— Interment _— Disinterment Temporary Marker Preparation & Installation M Z/ AM WK • - - =�•. The following documents were provided as Proof of Residency: I: \W W- DATA \Ms- Cemetery\RECEIPT.doc I and , wj Lfi • . ........ . ........... DECEV NAME: PLEASE PRINT -DAP, DATE OF BIRTH: (Month) DATE OF DEATH: (Month) SIGNATURE:Z�L PRINT SIGNA DATE: —"-) — (Day) (Day) (Year) 26.4 (Year) - - - - - -------- FOR OFFICE USE ONLY Unit 3 S/N/B COLUMBERIUM: �/ /i1 16 NICH 3 � NUMBER: CITY OF SEBASTIAN CITY CL REERK'S OFFICE 4558 ill �7 Ii CEI1IPPT I i C Nam IV"-" • V ❑ Cash Date I a /(4 �j Chock No. Amount Paid 001001208001 Sales Tax 001501322900 Garage Sales 001501341920 Copies/Bid Specs. 001501341910 LDC/Code of Ordinances 001501341930 Election Qualifykig Fees 601010 343800 Cemetery Lots *J—iq-66 Lot/Niche Block �, Unit 001501343805 Cemetery Fees olc, oa r Total Paid C� v b White - Dept of Origin • Yellow - Finance • Pink • Applicant �q Sty CITY OF SEBASTIAN CHECK REQUEST Accounting Use Only Input Date Fiscal Period Document # Entered By Document Amount # of Lines Total HC Hash To Be Completed By Department Due Date 7/10/2009 Single Check Y / N Y Vendor Number Document Organization Object Project LN TC Reference Code Code Code Amount 601010 343800 $150.00 Amount $150.00 Description Daughter overpaid to have her mother's cremains interred. Unit 3, COL, Niche 39SN (only three cars present, so should be interment with no service involved) ISSUE CHECK TO NAME Kathryn Maynard ADDRESS 4321 County Road #4 Montour Falls, NY 14865 APPROVED BY DATE 6/24/2009 BUDGET APPRO L (534000 AND 535450 ONLY) =Y OF SEBASTIAN WACHOVIA CHECK NO.071886 225 MAIN STREET 71886 � SE BAS71AN 32358 GENERAL ACCOUt,'7 C 11 32509 07/10/200 $150.00 ********150 DOLLARS AND NO CENTS JAW ',F' Kathr n Maynard ID �FNOT PAID WITHiN ©n DAYS 4321 �ount Road #4 Montour Fayls NY 14865 TWO SIGINATURES REQUIRED 11'07 L88611' 1:06700C3 4321:20000273L6 296 'in 71886 SEBASTIAN, FL 32958 —7 ;1NIVOICE NUMBER INVOICE DESCRIPTION 06/24/09 REFUND !overpayment interment 132509 Kathryn Maynard 071009 071886 NET INVOICE Ar\40U.%'T-----\ 0 150.001 70929 150.00 71886 CITY OF SEBASTIAN CITY CLERK'S OFFICE /, p RECEIPT 4 F U Name ���cr.ib ❑Cash Date Check No. - � . � L Amount Paid 001001 208001 Sales Tax 001501 322900 Garage Sales 001501 341920 Copies/Bid Specs. 001501 341910 LDC /Code of Ordinances 001501 341930 Election Qualifying Fees 601010 343800 Cemetery Lots Lot/Niche _ , Block (?' Unit_ 001501 343805 Cemetery Fees o fi ors Total Paid �� U __. initials �""► ' ` l n (e r White - Dept. of Origin • Yellow - Finance • Pink - Applicant olve