HomeMy WebLinkAbout4-08-39bCIiYOF
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NOME OF PELICAN ISLAND
Certificate No. 2316
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Certificate of Interment Rights
IN ACCORDANCE with provisions of the Code of Ordinances of the City of
Sebastian, it is hereby certified that:
.7ack Bond &/or Rochelle Manotas
109 Arcadia Drive
Sebastian, FL 32958
In and for consideration of the sum of $1,000.00 is entitled to full interment
rights in the Sebastian Municipal Cemetery for the following lot:
Unit 4, Block 8, Lots 39 a& b
of the Sebastian Municipal Cemetery,
as maintained on file in the records of the City Clerk
for use in accordance with the conditions, ordinances, resolutions, rules and
regulations prescribed therefore by the City of Sebastian.
CONVEYED THIS 9th day of )anuary, 2012.
CITY OF SEBASTIAN, FLORIDA
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� AI Minner
City Manager
ATf EST:
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Sally . Maio, MMC
City Clerk
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City of Sebastian Municipai Cemetery Purchase Receipt
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To enable the City of Sebastian to determine the correct rate, and in accordance with cemetery rate
regulations, proof of City residency of purchaser or person for whom lot is intended for interment must
be provided at time of purchase.
�-�or I�oGh�ll� �l�n�
Name(s) ' .
� �`1 /`i {'C C�1�t_ �� � Y I V' e. � S 2%J 0. S-�"1 C�, Y� ��. J� g 5� —
Address ,. _
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Area Code & Phone Number
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Name & Residence Address of Intended Occupant if Other Than Purchaser
OFFICE USE ONLY
Receipt is acknowledged in the sum of:
rs($ d00_�C'.
on this. day of , 20 for the purchase of the following described
Cemetery Lot(s) and/or Niche(s).
Unit _�, Block �, Lot(s) ���CL�I-�j Niche(s)
for use in accordance with the conditions, ordinances, resolutions, rufes and regulations prescribed
therefore by the City of Sebastian.
Additional Fees paid at time of purchase:
Corner Markers (set of 4-$20) Opening & Closing
Vase and Ring for Niches (cost)
Temporary Marker Preparation & Installation
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S nature of Purchaser
!:\W W-DATA1Ms-Cemetery\RECEIPT.doc
Interment
/W O H
Circle One
Disinterment
TOTAL $ lD�D. DD
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The following documents were provided as Proof of
Residency:
and
CITY OF SEBASTUIN 4 4 2 9
CITY CLERK'S OFFICE •
RECEIPT
Name v�`�'" � � h� ❑ Cash
Date ( � 'Z —" � Z f�(Check #��
No. Amount Paid
001001208001 Sales Tax
001501322900 Garage Sales
001501341920 CopieslBid Specs.
001501341910 LDCICode of O�dinances
001501341930 Election Qualifying Fees
601010 343800 Cemetery Lots �� O�
�� LotlNiche c�.� h. Blodc v , Unit �
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001501343805 Cemetery Fees
W^ ' Total Paid �� � 0
Initials
White - Dept. of Origin • Yellow - Finance • Pink • Applicant