HomeMy WebLinkAbout4-04-16CITY OF
HOME OF PELICAN ISLAND
CITY OF SEA STIAN
Certificate No. 2295
Certificate of Interment Rights
IN ACCORDANCE with provisions of the Code of Ordinances of the City of
Sebastian, it is hereby certified that:
Rene /or Karen VanDeVoorde
12470 Roseland Road
Sebastian, FL 32958
In and for consideration of the sum of $4,000.00 is entitled to full interment
rights in the Sebastian Municipal Cemetery for the following lots:
Unit 4, Block 4, Lots 16 17
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 20 day of April, 2011.
CITY OF SEBASTIAN, FLORIDA ATTEST:
Minner Sally Maio, MMC
City Manager City Clerk
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.
tech e a_via /or i<l';Lren Van DeVoo
Name(s)
1,2_11 7 O go s el ctnd Road ebas l r,
Address
5. -9666
Area Code Phone Number
Name Residence Address of Intended Occupant if Other Than Purchaser
OFFICE USE ONLY
FL 3Zgt5
Receipt is acknowledged in the sum of:
e Dollars 406C).p0
on this day of 20 for the purchase of the following described
Cemetery Lot(s) and /or Niche(s).
Unit Block 4 Lot(s) Up 4 1 1 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 0 H
Circle One
Vase and Ring for Niches (cost)
Temporary Marker Preparation Installation
4te.4,_
Si nature of Purchaser
I: \W W- DATA \Ms Cemetery \RFCEI PT. doc
Interment Disinterment
y of Sebastian
TOTAL a0 0
TOTAL
The following documents were provided as Proof of
Residency:
and
CITY OF SEBASTIAN
CITY CLERK'S OFFICE
RECEIPT
Name 1 Van be kord e. IA Cash
Date 4 10 I1 *heck ft 4349
No. Amount Paid
001001 208001 Sales Tax
001501 322900 Garage Sales
001501 341920 Coples/Bid Specs.
001501 341910 LDC /Code of Ordinances
001501 341930 Election Qualifying Fees
601010 343800 Cemetery Lots
Lot/Niche 16 Block
001501 343805 Cemetery Fees
4 Unit 4
Initials
White Dept. of Origin Yellow Finance Pink Applicant
4298
Total Paid 4.—
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Example :
STRUNK FUNERAL HOME & CRE ATORY
1623 No. Central Ave.
SEBASTIAN, FL 32958
(772) 589-woo '
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