HomeMy WebLinkAbout3-COL-29DsAName
Unit
Block �h
Lot S
Date of Mark -out
A
Date of Burial.� R _ Time
Name of Funeral Home
Authorized by 41aLl,
SEAW INNS CREMATORY
Sebastian, Florida
735 Fleming Street • Sebastian, Florida 32958
www.seawindsfli.com
(772)589-1933
We hereby certify that these are the remains of JOHN J. KRUCKO
64 V/
.The remains were received
from SEAWINDS FUNERAL HOME & CREMAT-ORY
Cremation Permit No.14-73380-5057 Issued at INDIAN RIVER COUNTY
Date of Death FEBRUARY 22, 2014
4 �'
Date of Cremation 2 z By
Cremator
Certificate No. 2233
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:
John J. &/or Maria L. Krucko
167 S. Wimbrow Drive
Sebastian, FL 32958
In and for consideration of the sum of $2,000.00 is entitled to full interment
rights in the Sebastian Municipal Cemetery for the following niche:
Unit 3, Col, Niche 29dsa
of the Sebastian Municipal Cemetery,
as maintained on file in the records of the City Clerk
for use in accordance with the conditions, ordinances, resolutions, rules and
regulations prescribed therefore by the City of Sebastian.
CONVEYED THIS 9t" day of September, 2009.
C
N, FLORIDA
X41 Minner
City Manager
ATTE , :
1Vl
Sally . Maio, MMC
ity Clerk
Total Paid 50
Initials
White - Dept. of Origin • Yellow - Finance • Pink - Applicant
CITY OF SEBASTIAN
CITY CLERK'S OFFICE
RECEIPT
{, p
4 U
Namey- & k� k a el 11 Cash
2--27- Date
l 1 `t g Check #-
No.
Amount Paid
001001 208001
Sales Tax
001501 322900
Garage Sales
001501341920
Copies/Bid Specs.
001501 341910
LDC/Code of Ordinances
001501 341930
Election Qualifying Fees
601010 343800
Cemetery Lots
LotlNiche Z d54 Block Ct Unit
,
001501 343805
Cemetery Fees (:Ac
-56), C)
Total Paid 50
Initials
White - Dept. of Origin • Yellow - Finance • Pink - Applicant
City of Sebastian Municipal Cemetery Purchase Receipt
To enable the City of Sebastian to determine the correct rate, and in accordance with cemetery rate
regulations, proof of City residency of purchaser or person for whom lot is intended for interment must
be provided at time of purchase.
,aria- L, Ki -a
Name(s)
1&-7 S. w i rn b ro w D i iy-e. Se�b�S t r cZ n f L 3Z q 58
Address
Area Code & Phone Number
Name & Residence Address of Intended Occupant if Other Than Purchaser
OFFICE USE ONLY
Receipt is acknowledged in the sum of:
JWD 'V UW �. a`Id Ae--o Dollars ($ c2_00 0 10.0
on this. 3 Kd day of 4- , 20 Qq for the purchase of the following described
Cemetery Lot(s) and/or Niche(s).
Unit -3 , Block , Lot(s)
Niche(s) cZ9 of S Q
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 -/W O H
Circle One
Vase and Ring for Niches (cost) , OU Interment Disinterment
Temporary Marker Preparation & Installation
Signature of Purchaser
1:\WW-DATAWIs-Cemetery\RECEI PT. doc
TOTAL $ c7-0(06 00
W
4ity of Sebastian
The following documents were provided as Proof of
Residency:
and
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