HomeMy WebLinkAbout4-11-32JEANNE FICKE
Mrs. Jeanne Ficke, 89, died May 28, 2013 at Bethesda on Turkey
Creek Assisted Living Facility in Palm Bay. She was born January
12, 1924 in Ripley, Ohio and lived in Sebastian coming from
Dayton, Ohio in 1986. She was a member of Sebastian United
Methodist Church.
Survivors include daughter Barbara Brown (Don) of Sebastian,
granddaughters Mindi Casella (Rob) and their children Garner
and Grant of Richmond Hill, Georgia and Shelli Grose (Russell)
and their children, Lyndsi, Zachary and Blake of Oviedo, Florida,
brother -in -law Albert Ficke and sister -in -law Shirley Ficke, both of
Cincinnati, Ohio.
She was preceded in death by her husband of 66 years Mack
G. Ficke, sisters Goldie, Mary, Catherine, Margaret, Ruth and
Anne, brothers Bill and Bob.
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Date of Mark -out
Date of Burial f/3 Y // 3 '
Name of Funeral Home -5 h✓ K-
Authorized
Time
CITY OF SEBASTIAN
CITY CLERK'S OFFICE 4388
RECEIPT
Name 5tru.n k/ ri cke
Date 6 /
No.
0 Cash
Check# &
Amount Paid
001001208001
Sales Tax
001501322900
Garage Sates
001501341920
CopiesBid Specs.
001501341910
LDCICode of Ordinances
001501341930
Election Qualifying Fees
601010
343800
Cemetery Lots
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LoUNiche Block
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( Unit
001501
343805
Cemetery Fees
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Initials
White - Dept. of Origin • Yellow - Finance • Pink - Applicant
FUNERAL DIRECTOR'S REQUEST TO CITY OF SEBASTIAN
FOR BURIAL OPENING IN SEBASTIAN MUNICIPAL CEMETERY
MM
NOME OF P"AN I$Lw
For information contact:
Kip Kelso - Cemetery Sexton
Sebastian Municipal Cemetery
(772) 589 -2545
City Clerk's Office
City Hall, 1225 Main Street
Sebastian, FL 32958
Office (772) 388 -8215 or 388 -8214
Fax: (772) 589 -5570
FUNERAL HOME: $TnuNK FUNERAL HOME & CK11P,70IRY
o. C entra FKv e.
ADDRESS: SEBASTIAN' EL 32958
PHONE #: (772) 5591000 ..
(qqq,ck One) - -- - l ( D &A
OPEN BURIAL LOT Lot 3 2 Block Unit 4
OPEN CREMAINS LOT Lot Block Unit
OPEN COLUMBARIUM NICHE Niche Block Unit
N S E W
BURIAL DATE ANDSERVICE TIME: ��3 / J/ — 2- :00 —
—
O 'i
FOR DECEASED: 0 Jtatx n
Name
NAME AND SIGNATURE OF LOT OWNER OR REPRESENTATIVE:
(Must provide proper documentation of ownership)
Name Sionature at,-
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 FUNS DIRECTOR:
iell r a
Name ignature D to
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:
Ce et Sexton ate
This form to be provided to Clerk's Office by Sexton for permanent record upon completion.
f I
R lDDII'AACbtITAF'. , State of Florida, Department of Health, Bureau of Vital Statistics
EALT BURIAL TRANSIT PERMIT
DATE PRINTED: May 28, 2013 TRACKING NUMBER: 2013078867
1. DECEDENT INFORMATION
Name of Deceased Date of Death
GLORIA JEANNE FICKE May 28, 2013
Place of Death - County City, Town or Location Name of facility, or street address if not a facility
BREVARD PALM BAY BETHESDA ON TURKEY CREEK- ASSISTED LIVING FACILITY
Name and Address of Funeral Home /Direct Disposal Establishment Fla. Lic. No. /Reg. No. Phone Number
STRUNK FUNERAL HOME- SEBASTIAN F041870 F041870 (772) 589 -1000
1623 N CENTRAL AVE
SEBASTIAN, FLORIDA, 32958
Funeral Director /Direct Disposer "- - _ _ Fla. Lic. No. /Reg. No.
2. BURIAL - TRANSIT PERMIT
The Florida Department of Health, Bureau of Vital Statistics
hereby grants permission to dispose of this body in accordance with Chapter 382, Florida Statutes.
Permit Number: 2013- FO41870 -5086
Date Issued: May 28, 2013
Meade Grigg, State Registrar
I AUTHORIZATION for CREMATION, DISSECTION, BURIAL -AT -SEA, or HOSPITAL DISPOSITION
Authorization given by Medical Examiner District Approval Number:
4. CEMETERY OR CREMATORY
Place of Disposition: SEBASTIAN CEMETERY
Method of Disposition: BURIAL Date of Disposition:
EDRS maintains all statutorily required information regarding the death record and related
burial transit permit, therefore, returning the permit to the county health department is no
longer required.
If the Place of Final Disposition wishes to retain the copy of the permit for their file they may do so.
DH 326E, 10/12
64V- 1.011, Florida Administrative Code
IN ACCORDANCE with provisions of the Code of Ordinances of the City of
Sebastian, it is hereby certified that:
Mack G. & /or Jeanne Ficke
186 Main Street
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 lots:
Unit 4, , Block 11, Lots 32, 33
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 21St day of April, 2010.
CITY OF SEBASTIAN, FLORIDA ATTEST:
'7 LAI Minner Sally A. Maio, MMC
City Manager City Clerk
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