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HomeMy WebLinkAbout2-17-03I/ P % v ,, �� �� ✓ Y 'P' /; pony Remains To Destination 1— 4 State of Florida Full name of deceased Place of death ,e/7 z/02 Dopr—erient of Health and Rehabilitative Service • Divisio of Health Burial Permit No. Health BURIAL-TRANSIT PERMIT Lillia$ Posey Kelly Sebastian Indian River Florida (city) (County) Date of death October 30 19 75 Color Sex f Age 71 Method of disposal 5urial Sebastian CeneIery (Cemetery or Crematory) County (Whether burial, cremation, transportation, storage, etc.) Indian River State Fla. A certificate of death having been filed as required by the laws of this State, permission is hereby given to D-qllel P. Pottinger License No 1579 (Funeral Director or person acting as such) to dispose of body of said deceased as above stated. Date issued 10-31-75 av1A-a.. L,7 (Registrar) OUT SPACE BELOW (Cemetery of-Grepargel. Signature Signature ea? METERY OR CREMATORY AUTHORITY SHALL, FILL fraYe Body was... on , (State whether cretmrtect, buried, stassell-etc.) Place.. V.S.,640 This permit must be endorsed by the Sexton (or by the Funeral Director where there is no sexton) and re- turned within 10 days to the Registrar of the district in which the burial takes place. (*letetotr-or person In charge) Daniel R. Pattinger FUNERAL DIRECTOR • Colonial Axxneral Plante South Indian River Drive (4rbastian, 3Flariba 32958 LILLIAN P KELLY NNI702/ f' /975 Pima ireleJltmte 589 -4009 ar 589 -91300 o v .S /97, 1 lavAl '' — taL Lt/,I ii _Sebuziiatt'S A1rst !finest 'SERVING ALL OF INDIAN RIVER AND BREVARD COUNTY' 7--Xaoci Paid by General Receipt No. 44 List Price $. 175 'DO Discount $ -- Net Paid $ 175.00 R &R A • Dated Nov 3, 1975 Maximum No. Burial spaces Total area in square feet — Monument permitted fl a t (Data above this line for City Record only) mrs. Julia Bepler Rt 3, Box 91 Sebastian, F1 32958 lives at Kx A l cottages (C BLOCK 17 LOT 3 Unit 2 (for Lillian P. Kelly - mot! Block 17 Lot 3 for mrs. Lillian P. Kelly mother of: Unit 2 DEED #282 mrs. Julia Bepler, Route 3 Box 91 Sebastian, Fl 32958 (Kentucky Colonel Kottages)