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Home My WebLink About4-11-06Certificate No. 2240 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: Steven C. Shade 525 Ponoka St., Sebastian, FL 32958 (name) (address) In and for consideration of the sum of $1,000.00 is entitled to full interment rights in the Sebastian Municipal Cemetery for the following lots: Unit 4 Block 11 Lots 06 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 23rd day of November, 2009. CITY 0 SE TIAN, FLORIDA ATTE Minner Sally .Maio, MMC City Manager City Clerk Name. L ' - /D �CNb4iN�7J % /i�S. Unit / Block_ Lot Date of Mark -out 'JM,! Ad Date of Burial � /� �� Time D '02 Name of Funeral Home XSA C-glw,!% `S /I — n Authorized by WIT Vh bUSASIIAN CITY CLERK'S OFFICE / C RECEIPT 4 U 4 Name )W �jV -f n r ❑ Cash Date a�. " O 0 Check # .5� No. Amount Paid 001001208001 Sales Tax 001501322900 Garage Sales 001501341920 Copies/Bid Specs. 001501341910 LDC /Code of Ordinances 001501341930 Election Qualifying Fees 601010 343800 Cemetery Lots 5+e LotMiche ( T _S�, Block Unit 001501 343805 Cemetery Fees 150. 01D Total Paid 50.00 Initials White - Dept. of Origin • Yellow - Finance • Pink . Applicant In Memory of Steven Charles Shade June 14, 1959 - February 12, 2010 Steven Charles Shade, 51 of Sebastian, FL passed away on Friday, February 12, 2010 at his residence. He was born June 14, 1959 in Levittown, PA and moved to Sebastian two and a half years ago from Port St Lucie, FL. Mr. Shade was a copy machine technician for Light Source Business Systems in Vero Beach, FL and was an avid fisherman Survivors include his three sons Steven Shade, Jr. of Port St Lucie, FL; Brian Shade and Brandon Shade of Sebastian, FL; parents Charles and Marjorie Shade of Pompano Beach, FL; sisters Marjorie Lynn Shade of Barrington, NJ, Christine Schlegel of Roanoke, TX, Diane C. Lunsford of Snellsville, GA; many nieces and nephews. He was predeceased by his wife Pamela Christina Shade. A memorial service will be held at 2:00 PM on Saturday, February 20, 2010 at his residence: 525 Ponoka St., Sebastian, FL 32958. Arrangements by Seawinds Funeral Home & crematory, Sebastian, Florida. Atlas Crematory 2111 S. US Hwy 1 Rockledge, Florida 32955 (321) 635 -1973 We hereby certify that these are the remains of Steven Charles Shade The remains were received from Seawinds Funeral Home Funeral Home Sebastian, Florida City and State 10 -0203 Cremation Permit # Date of Death: February 12, 2010 Date of Cremation: February 17, 2010 By. Dave Reid Cremator 29682 Chip /D # A79 ll AS CREMA7®R'Y Rockledge, Florida 2111 U.S. #1 South Rockledge, Florida 32955 (321) 636 -4275 TO Seawinds Funeral Home This envelope contains certificate of Steven Charles Shade Name Unit Block Lot Date of Mark -out Date of Burial fIf - jl �i Time C w Name of Funeral Hoiue 6 FUNERAL DIRECTOR'S REQUEST TO CITY OF SEBASTIAN FOR BURIAL OPENING IN SEBASTIAN MUNICIPAL CEMETERY .MIN S askil-W HOME OF PELICAN ISLMD For information contact: Kip Kelso - Cemetery Sexton Sebastian Municipal Cemetery (772) 589 -2545 i FUNERAL HOME ADDRESS: -735 PHONE #: 5-8 q — !9 .?3 City Clerk's Office City Hall, 1225 Main Street Sebastian, FL 32958 Office (772) 388 -8215 or 388 -8214 Fax. (772) 589 -5570 IN y (Check One) ./OPEN BURIAL LOT Lot lU Block Unit_ OPEN CREMAINS LOT Lot Block Unit OPEN COLUMBARIUM NICHE Niche Block Unit N S E W BURIAL DATE AND SERVICE TIME: Z — h9 -1O (Tjk� FOR DECEASED: .S-` - Eyle7d T �C Name AME AND SIGNATURE OF LOT OWNER OR REPRESENTATIVE: (Must provide proper documentation of ownership) lnu,'OP6�- - ,��OQA,A24 Name Sign re Date I certify that I have determined the ownership of the a ve described site, that all site fees and administrative fees have been paid and authorize opening of same. NAME AND SIGNATURE OF LICENSED FUNERAL D ECTOR: Name ignature Date Cemetery Sexton Certification: I certify that I have checked the ownership information by viewing the owner's deed and confirming with Clerk's office and that all fees have been paid: Oeme/WSerxfon Date This form to be provided to Clerk's Office by Sexton for permanent record upon completion. Obituaries I Death Notices I Newspaper Obituaries I Online Obituaries I Newspaper Death Notices I Onli... Page 1 of 1 PAMELA CHRISTINA SHADE Pamela Christina Shade, 47, died Nov. 20, 2009, at her home. She was born in Cleveland and lived in Sebastian for two years, coming from Port St. Lucie. She was employed by Walgreens for two years in Sebastian. She was a licensed massage therapist. Her beliefs were that of a Jehovah's Witness. Survivors include her husband of 23 years, Steven Shade of Sebastian; sons, Steven Shade Jr. of Port St. Lucie and Brian Shade and Brandon Shade, both of Sebastian; brothers, William Brown Jr. of North Royalton, Ohio, and Robert Brown of Port St. Lucie; sisters, Patricia Navarro of Sunnyside, Ga., Diana Kirst of Griffin, Ga., and Laura Weathers of Port St. Lucie; mother, Ethleen Brown Page of Palm Springs; and father, William Brown of Port St. Lucie. Services: Visitation will be from it to 1 p.m. Nov. 27 at Seawinds Funeral Home Chapel in Sebastian. A service will be at 1 p.m. with the Rev. Allen Kirst officiating. Interment will be at Sebastian Cemetery. A guest book may be signed at sea windsfh.com /obit.php. Published in the TC Palm on 11/24/2009 Today's TC Palm obituaries Questions about obituaries or Guest Books? Contact Legacy.com • Terms of use Powered byLegacy.com, obituaries nationwide Back http:// www .legacy.com/tcpalm/Obituaries. asp? Page= LifeStoryPrint &PersonID= 136373789 11/25/2009 CITY OF SEBAST �LAN Q-00MINNO HOME OF PELICAN ISLAND 1225 Main Street Sebastian, FL 32958 (772) 589 -5330 Phone (772) 589 -5570 Fax November 25, 2009 Mr. Steven C. Shade 525 Ponoka Street Sebastian, FL 32958 RE. Interment Rights to Unit 4, Block 11, Lot 06 Sebastian Cemetery Dear Mr. Shade: Enclosed is City of Sebastian Certificate 2240 entitling you to full interment rights in Unit 4, Block 11, Lot 06. Also enclosed is a copy of the Rules and Regulations governing the Sebastian Municipal Cemetery. If you have any questions, please contact our office. Sin rely, Sally A. aio, MMC City Clerk SAM:dwc enclosures arfO SERASn..iV �Oqo ROME OF PELICAN ISIAND 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, residence of purchaser or person for whom lot is intended for interment must be provided at time of purchase /Auu1 ubb Area Code & Phone Number Residence Address of Intended Occupant if Other Than Purchaser Office Use Only Receipt is acknowledged in the sum.of: Dollars ($ on this 3 day of ^ L'. , 20 for the purchase of the following described Cemetery Lot(s) and /or Niche(s). Unit , Block ( , Lot(s) ob 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 W O H!� Circle One Vase and Ring for Niches (cost) Interment Signature of Purchaser City of Sebastian Disinterment TOTAL $J�� z O� Service fees are to be paid at time of need only 1: \W W- DATA \Ms - Cemetery\RECEI PT. doc i e �o 0 ir w O CD 9W S2 r LL N O r d LU Al i5 t La. ru r0r C V rJ z A a 0 a t Y N A t U � 1 u rT—F I AO O cC�'7 NN C7 p8 oM uC� p� 2 0 Z S S O S S c S v � � o 1 'V ' L q� co U' U J W U J CJ wCw A Y t. r e d s w C 3 .4� o` O 1 mma, - J J N O cC�'7 NN C7 p8 oM uC� p� 2 0 Z S S O S S c S wCw A Y t. r e d s w C 3 .4� o` O 1 mma, - J J FLORIDA DEPARTMENT OF X' HEALT A /Tvpr=1 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 PAMELA CHRISTINA SHADE Death 11/20/09 2. Place of Death City, Town or Location Name of (If neither, give street address) County Hosp. or INDIAN RIVER SEBASTIAN Inst. 525 PONOAKA ST 3. Name of Medical Address Phone Number Certifier LINDA O' NEIL, MD 2500 S. 35TH ST X Medical Examiner ElPhysician FT. PIERCE, FL 34981 772- 464 -7378 4. Name of Funeral Home /Direct Disposal Address Fla. Lic. No. /Reg. No. Phone No. (Area Code) Establishment 735 S. FLEMING ST SEAWINDS FUNERAL HOME SEBAESTIAN, FL 32958 2617 772- 589 -1933 5. Check a. JXJ The medical certiticatlon has been completes ana slgneo. A completea cernncate or oeatn accompanies uus Appropriate application. Box b. [--j was contacted on He /she verified that this death was from natural causes, that there was no accident nor other external cause of death, and that will complete and sign the medical certification of cause of death within 72 hours. C. r'-j was contacted on He /she verified that Medical Examiner, will complete and sign the medical c§rtification of cause of death within 72 hours. 6. Funeral Director/ Ignature F.E. No. /Reg. No. Date Signed Direct Disposer FO 44126 11/23/09 B. BURIAL - TRANSIT PERMIT Permission is hereby granted to dispose of this body. Permit No. 09- 2617 -237 ❑ 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. )E]No extension of time for filing tdt tic has been requested. Registrar or Date Date Certificate Subregistrar Signature Issued: 11/23/09 Dye: 11/27/09 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 0BURIAL STORAGE Date of Disposition 11/27/09 OCREMATION FJOTHER (Specify) Signature of Sexton f . or Person -in- Charge ' 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, 8197 (Obsoletes all previous editions) Yellow: Funeral Director or Direct Disposer (Stock Number: 5740 - 000 -0326 -2) Pink: Local RegistrarrN pyv t FUNERAL DIRECTOR'S REQUEST TO CITY OF SEBASTIAN FOR BURIAL OPENING IN SEBASTIAN MUNICIPAL CEMETERY MIT SEA„ N HOME OF PELICAN ISLAND For information contact: Kip Kelso - Cemetery Sexton Sebastian Municipal Cemetery a` (772) 589 -2545 FUNERAL HOME: SLAW 101, City Clerk's Office City Hall, 1225 Main Street Sebastian, FL 32958 Office (772) 388 -8215 or 388 -8214 Fax: (772) 589 -5570 ADDRESS: V13S F 'lam a�i Nq Sr 19A S T1 NjJ +� PHONE #: 17 2. 516 °I- IA'3'3 (Check One) OPEN BURIAL LOT Lot Block Unit OPEN CREMAINS LOT Lot Block Unit OPEN COLUMBARIUM NICHE Niche Block Unit N S E W BURIAL DATE AND SERVICE TIME: H-7--j-001 FOR DECEASED:r-PA y ik A C. S k N (,11 Name NAME AND SIGNATURE OF LOT OWNER OR REPRESENTATIVE: (Must provide proper documentation of ownershi Name Signature Date I certify that I have determined the ownership of the above described site, that all site fees and administrative fees have been paid and authorize opening of same. NAME AND SIGNATURE OF LICENSED FUNERAL DIRECTOR: ,5o,r-. H-o17• -n1 Name Signature Date Cemetery Sexton Certification: I certify that I have checked the ownership information by viewing the owner's deed and confirming with Clerk's office and that all fees have been paid: 1Z 0- 1,1eP(-)7 - - I '2 a , e et Sexton Date This form to be provided to Clerk's Office by Sexton for permanent record upon completion. 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L'd 6176L-9WZLL 6unoAwif d6b:l0 l l 80 deS