HomeMy WebLinkAbout4-04-27L
NA I Minner
Ci y Manager
CffY OF
HOME OF PELICAN ISLAND
CITY OF SEB t STIAN
Certificate No. 2300
Certificate of Interment Rights
IN ACCORDANCE with provisions of the Code of Ordinances of the City of
Sebastian, it is hereby certified that:
Deborah L. White
111 Capri Avenue
Sebastian, FL 32958
In and for consideration of the sum of $3,000.00 is entitled to full interment
rights in the Sebastian Municipal Cemetery for the following Tots:
Unit 4, Block 4, Lots 26, 27, 28
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 31 day of May, 2011.
CITY OF S BASTIAN, FLORIDA ATTEST:
Sally A. Maio, MMC
City Clerk
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.
bJ oraJ1 L. A16,i
HOME OF PELICAN ISLAND
Name(s)
Il Cap ri Ave, Sebo.sfi an FL 32_q
Address
7 7 Z) 473 ZO
Area Code Phone Number
Ob
Name Residence Address of Intended Occupant if Other Than Purchaser
a.( I2anQ(d liu1ii +e /t a.gr I -Ieltn ,Sri't/- (Eayctrgcinq J in I 1 riv Nafl Cerntfery)
L7 Deloovah ►nlh i f-t OFFICE USE ONLY
R eceipt is acknowledged in the sum of:
�l�lll -Q.Q, ✓t t IM /LOC a4. a tvL Dollars 3006.
on this 3 1 S r day of Mal 20 11 for the purchase of the following described
Cemetery Lot(s) and /or Niche(s).
Unit `t Block 4 Lot(s) v o, 02 7 2R 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 50 00
Circle One
Vase and Ring for Niches (cost)
Temporary Marker Preparation Installation
I: \1 AN- DATA \Ms- Cemeteny\RECEIPT.doc
Interment Disinterment
H
TOTAL 3150. U o
it ,L 4/l.o,l W
Signature of Purchaser ty of Sebastian
The following documents were provided as Proof of
Residency:
and
WA22ca
CITY OF SEBASTIAN
CITY CLERK'S OFFICE
RECEIPT
Initials
White Dept. of Origin Yellow Finance Pink Applicant
4305
Name t) by ra-h (AJ T e Cash
Date `ay �v 3 i (I )(Check ft L J /S
6
No. Amount Paid
001001 208001 Sales Tax
001501 322900 Garage Sales
001501 341920 Copies/Bid Specs.
001501 341910 LDC /Code of Ordinances
001501 341930 Election Qualifying Fees
601010 343800 Cemetery Lots J 3000.
Lot/Niche 2 at
Block `T 'T Unit
001501 343805 Cemetery Fees 50, 00
Total Paid 3
1.50 0 00