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Certificate No. 2228
cI°i'Y oF SasTIm
Certificate of Interment Rights
IN ACCORDANCE with provisions of the Code of Ordinances of the City of
Sebastian, it is hereby certified that:
ti Jacquelyn B. DeVane 8520 U.S. Highway 1, Micco, Fl. 32976
(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 lot:
Unit 4, Bilk 11, Lot 34
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 7t' day of July, 2009.
CI OF EBASTIAN, FLORIDA
Al Minner
City Manager
ATTEST:
Sally .Maio, MMC
ity Clerk
CITY OF SEBASTIAN 11698
ADMINISTRATIVE SERVICES RECEIPT
Name JE v ftr11C CCash
Date rD ja�t 11 0 Check #
O Credit
Amount Paid
001001 208001 Sales Tax
001001 220000 Security Deposit
001501 362100 Taxable Rent
001501 362150 Non -Taxable Rent
450010 369900 Airport Badge
001001218010 CobraServe
001501 354100 Code Enforcement Fines
001501 347557 Community Center Revenue
001501341920 Copies
001501 351140 Parking Citation
001501 342100 Police Security Services
001501 329200 Site Plan Review
001501 329300 Subdivision/Plat Review
001501 329100 Zoning Fees
(obl old 343800 lCali.cJv
L-Yea4m&:2 t1-4 6-11 - Lo7 34
IO2 0-
3 L1C_r e4 Total Paii
Initials
White - Dept. of Origin - Yellow - Admin. Svcs. - Pink - Applicant
Certificate No. 2228
~~ ~ ~~
Certificate of Interment Rights
IN ACCORDANCE with provisions of the Code of Ordinances of the City of
Sebastian, it is hereby certified that:
Jacquelyn 6. DeVane 8520 U.S. Highway 1, Micco, FL 32976
(name) (address)
In and for consideration of the sum of $2,000.00 is entitled to full interment
rights in the Sebastian Municipal Cemetery for the following lot:
Unit 4, Blk 11, Lot 34
of the Sebastian Municipal Cemetery,
as maintained on file in the records of the City Clerk
for use in accordance with the conditions, ordinances, resolutions, rules and
regulations prescribed therefore by the City of Sebastian.
CONVEYED THIS 7t" day of July, 2009.
OF/SEBASTIAN, FLORIDA
AI Minner
City Manager
ATTEST:
~~
Sally .Maio, MMC
ity Clerk
GFIY c)F
~~~~~ ~
~~ J~( ~~
HQME Of Pd+LICAN 15L11N[Q ^ ~-
City of Sebastian Municipal Cemetery Purchase Receipt
To enable the City of Sebastian to determine the correct rate, and in accordance with cemetery rate
regulations, proof of City residency of purchaser or person for whom lot is intended for interment must
be provided at time of purchase.
Name(s) '
~5z a u.s ~ c. A-to+ ~- ~ Crn ~ ego)
Address .3Z9 7 ~
C 7 7 z (~ G~ ~ -Colo ~
Area Code & P one Number
Name & Residence Address of Intended Occupant if Other Than Purchaser
OFFICE USE ONLY
Receipt is acknowledged in the sum of:
ro ~E~'~su,aa.v~.cQ "4~
~6'-D
Ilars ($ ~~~D• no
on this day of , 20 for the purchase of the following described
Cemetery Lot(s) and/or Niche(s).
Unit `~' ,Block ~ ~ ,Lot(s) .3~ 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 ~ Sb . V O
Vase and Ring for Niches (cost)
Interment
Temporary Marker Preparation & Installation
O H
Circle One
Disinterment
TOTAL $ 02 15`D . UO
_ ~-
ig ure of urchaser
of Sebastian
The following documents were provided as Proof of
Residency:
I:\WW-DATA\Ms-Cemetery\RECEIPT.doc I and
CITY OF SEBASTU-N
CITY CLERK'S OFFICE
RECEIPT
4 5 6 6
~
Name ^ Cash
Date ~ ~ -7
r ~ ~ ~Check# .j 5(0
No. Amount Paid
001001208001 Sales Tax
001501322900 Garage Sales
001501341920 CopieslBid Specs.
001501341910 LDCICode of Ordinances
001501341930 Election Qualifying Fees
601010343800 Cemetery Lots oZ~d d ~
LoUNiche ~, Block I ~ ,Unit
001501343805 F
C
t ~ 5a
a0
eme
ery
ees ,
w Total Paid ~/ r, n 0~0
Initiah: -~-- ~ ~
White - Dapt. of Origin • Yellow -Finance • Pink -Applicant